High-Deductible Health Plans Linked To Reduced Buprenorphine Use Among Adults With OUD

June 11, 2026

Privately insured adults receiving buprenorphine treatment for opioid use disorder (OUD) who switched to a high-deductible health plan (HDHP) experienced a significant reduction in buprenorphine use and, in some cases, fewer outpatient visits related to OUD treatment. Among all individuals who switched to an HDHP, the average number of days covered by an active buprenorphine prescription decreased by 29 days compared to those who remained enrolled in a non-HDHP. Among individuals whose deductible increased by more than $1,250, the reduction widened to 35.2 days, and those individuals also averaged one fewer OUD-related outpatient visit annually.

The researchers analyzed data from the Optum Labs Data Warehouse, a national commercial claims database containing deidentified information from more than 300 million enrollees between 2010 and 2023. The sample included 14,801 privately insured adults who had filled at least one buprenorphine prescription during a baseline year, maintained continuous enrollment throughout both the baseline and follow-up years, and either remained enrolled in a non-HDHP (13,214 individuals) or switched from a non-HDHP to an HDHP (1,587 individuals).

Among those who switched to an HDHP, the average amount paid per buprenorphine prescription increased from $42.00 to $51.80, while it decreased from $31.00 to $22.50 among those who remained enrolled in a non-HDHP. Similarly, average annual out-of-pocket spending across all health care services increased from $2,721.00 to $3,273.20 among those who switched to an HDHP, compared to a decrease from $2,531.70 to $2,322.20 among those who remained in non-HDHP coverage.

Among those who switched to an HDHP, individuals experiencing above-median deductible increases saw their average deductible rise from $1,462 to $3,163, compared to a smaller increase from $833 to $884 among those who remained enrolled in a non-HDHP. The number of OUD-related outpatient visits declined from an average of 5.9 to 5.0 visits annually among the above-median deductible subgroup, while increasing slightly from 5.3 to 5.5 visits among the non-HDHP comparison group.

Average out-of-pocket spending per OUD-related outpatient visit increased from $27.10 to $36.60 among individuals with above-median deductible increases and decreased from $24.10 to $21.40 among those who remained in non-HDHP coverage. In a sensitivity analysis limited to individuals with buprenorphine dispensing during the final quarter of the baseline year (77.8% of the HDHP group and 76.0% of the comparison group), findings were consistent with the primary analysis.

These findings were presented in High-Deductible Health Plan Enrollment and Buprenorphine Dispensing by Kao-Ping Chua, M.D., Ph.D.; Amy S. Bohnert, Ph.D.; Rena M. Conti, Ph.D.; Pooja Lagisetty, M.D.; Ushapoorna Nuliyalu, MPH; and Thuy D. Nguyen, Ph.D. The goal was to evaluate the association between switching to an HDHP, buprenorphine dispensing, and OUD-related health care visits.

The full text of High-Deductible Health Plan Enrollment and Buprenorphine Dispensing was published on May 28, 2026, by JAMA Network Open. A free copy is available (accessed June 3, 2026).

For more information, contact: Kao-Ping Chua, M.D., Ph.D., Associate Professor, Department of Pediatrics, University of Michigan, 2800 Plymouth Road, NCRC Building 16, SPC 2800, Room G026W, Ann Arbor, Michigan 48109-2800; Email: chuak@med.umich.edu; Website: https://medschool.umich.edu/profile/601/kao-ping-chua