Buprenorphine Medication May Decrease Expensive ER Visits for Pregnant Individuals with Opioid Use Disorder

CHICAGO – Pregnant women with opioid use disorder (OUD) have very high health care spending in the year before delivery – $33,000 per year, reports a study in the December issue of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA). Among patients who were prescribed buprenorphine for OUD, the study found that better adherence to their treatment regimen was associated with lower costs. Moreover, for pregnant women with OUD, medications for OUD including buprenorphine, may reduce the need for emergency room (ER) visits.

“Patients who follow their prescribed treatment more closely have reductions in hospital admissions and total health care costs,” said Eric C. Sun, M.D., Ph.D., co-author of the study and associate professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine, California. “Increasing access and adherence to buprenorphine may reduce high-cost, acute-care use during pregnancy.”

Treatment with evidence-based medications like buprenorphine is an important strategy for managing OUD during pregnancy. Using buprenorphine or other medications to reduce cravings and withdrawal symptoms has been shown to improve health outcomes – including a reduced risk of overdose – for patients with OUD.

The study included data on 4,661 pregnant patients with OUD who delivered between 2007 and 2023, drawn from a commercial insurance database. In the year before delivery, 40% of patients filled a prescription for buprenorphine.

Overall, pregnant patients with OUD had high health care costs in the year before delivery: about $33,000 (excluding costs related to the delivery itself). That was substantially higher than the annual health care cost for patients with diabetes, and comparable to that for patients with heart failure.

However, for patients taking buprenorphine, the rate of ER visits was significantly lower, with an average of 1.81 visits, compared to 2.35 in patients who did not take buprenorphine. On comparison of different patient subgroups, the decrease in ER visits was significant, mainly for patients who made more frequent prenatal care visits (at least 10 visits).

For patients who were prescribed buprenorphine, those who took buprenorphine more regularly, i.e., on at least 80% of possible days, experienced significantly lower health care costs and fewer hospital admissions, in addition to reduced ER visits, compared to those who did not.

“Our findings provide some support for current clinical guidelines by showing that treatment with buprenorphine may reduce the need for costly ER visits for pregnant patients with OUD,” said Dr. Sun. “Increased efforts to integrate addiction treatment into prenatal care may lead to better clinical outcomes while reducing health care costs.”

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 60,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

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