Research That Matters: Reduced Emergency Department Use Among Insured Individuals Receiving Extended-Release Buprenorphine in a Health System Setting

This study provides preliminary real-world evidence that initiation of monthly extended-release buprenorphine (XR-Bup) was associated with lower emergency department (ED) use and lower mental health or substance use-related inpatient utilization in an integrated health system. Among 99 patients who maintained insurance coverage for the full six months before and six months after XR-Bup initiation, the proportion with any all-cause ED use fell from 41% to 28%, and the mean number of ED visits fell from 0.63 to 0.30. The proportion receiving inpatient treatment for mental health or substance use-related reasons fell from 46% to 16%; both the number of stays and the number of inpatient days also declined.

The findings are encouraging, but they require a disciplined reading. This was a non-randomized, retrospective pre-post study with no comparison group. It demonstrates an association between XR-Bup initiation and lower subsequent utilization; it does not establish that XR-Bup caused the reductions, and it did not evaluate total health care expenditures or cost-effectiveness.