Disparities in OUD treatment: Buprenorphine vs. naltrexone

Understanding disparities in opioid use disorder (OUD) treatment

Pharmaceutical companies committed to advancing treatments for opioid use disorder (OUD) must understand the real-world access patients have to medications. A new retrospective study by researchers at Icahn School of Medicine at Mount Sinai, leveraging administrative claims from the HealthVerity Marketplace Private Source 20 database, shines light on racial, ethnic and insurance disparities in receiving two important medications: buprenorphine and naltrexone.¹

For pharmaceutical stakeholders, especially those marketing naltrexone, these insights are invaluable for pinpointing market gaps, aligning commercial strategy and driving equitable patient access.

Study overview: real-world data shows access to buprenorphine and naltrexone for OUD

Researchers analyzed over 176,000 opioid-related healthcare events from January 2017 to December 2022, assessing if patients received either buprenorphine or naltrexone within 180 days of these events. The study uniquely captures a broad spectrum of patients through HealthVerity Marketplace, drawing from claims covering approximately 70 million commercial insurance enrollees, 60 million Medicaid enrollees and 15 million Medicare Advantage enrollees across 150 payers.¹

Racial and ethnic disparities revealed in OUD medication prescribing

The findings highlight significantly higher prescribing trends for buprenorphine compared to naltrexone and some persistent racial disparities (Figure 1):

• Buprenorphine for OUD:

  • White patients had the highest adjusted estimated probability of receiving buprenorphine at 20.5%.
    
    
  • Black patients were significantly less likely, with a probability of only 17.1%.
    
    
  • Hispanic patients had an even lower adjusted probability (16.2%) of receiving buprenorphine
    
    

• Naltrexone for OUD:

  • The study found no significant racial or ethnic differences in the receipt of naltrexone, indicating more equitable prescribing practices for this medication.

Figure 1: White patients were more likely to receive buprenorphine than Black or Hispanic patients. Naltrexone access showed no significant racial or ethnic disparities.

These disparities underscore the critical need for culturally tailored approaches and targeted educational campaigns, areas where pharmaceutical companies can play a significant role in driving equitable healthcare outcomes.

Insurance type influences access to buprenorphine and naltrexone in opioid use disorder

Insurance type strongly influenced access to medication-assisted treatment (MAT):

• Patients with Medicaid (20.5%) and Medicare Advantage (12.5%) had higher odds of receiving buprenorphine compared to those with commercial insurance (13.1%).
  
  
• Conversely, patients with Medicaid and Medicare Advantage had lower odds of receiving naltrexone than commercially insured patients, highlighting different treatment accessibility pathways influenced by payer type.

For mid-market pharmaceutical companies, understanding insurance-based prescribing patterns is vital for informing payer engagement strategies, reimbursement discussions, and targeted patient-support programs.

How mid-market pharma can use these study insights

Pharma stakeholders, particularly those commercializing naltrexone, can leverage these findings to enhance market positioning. As buprenorphine demonstrates clear racial disparities, companies can differentiate naltrexone as a medication equally accessible across racial and ethnic groups. This can support efforts for broader payer acceptance and better clinical integration of naltrexone within comprehensive OUD treatment programs.

Furthermore, awareness of insurance-based disparities enables strategic planning of patient support programs that directly address specific coverage gaps, particularly within Medicaid and Medicare Advantage populations.

Accessing real-world data through HealthVerity Marketplace

By leveraging comprehensive, reliable data from HealthVerity Marketplace, this research provides actionable insights crucial for understanding market dynamics and treatment accessibility. Pharmaceutical companies utilizing HealthVerity Marketplace gain the advantage of precise, transparent and stable healthcare data, ensuring evidence-based decisions.

Key takeaways and next steps for pharmaceutical companies in OUD treatment

Disparities in medication-assisted treatment access for opioid use disorder remain persistent. Mid-market pharma companies have an opportunity to utilize these insights to improve equitable medication access and enhance patient outcomes.

Interested in harnessing real-world insights like these? Explore HealthVerity Marketplace and see how verified healthcare data can drive strategic decision-making in pharmaceutical marketing, patient engagement and beyond.

References

1. Khatri UG, Lopez C, Yen YT, Ling EJ, Richardson LD, Ngai KM. Receipt of buprenorphine and naltrexone for opioid use disorder by race and ethnicity and insurance type. JAMA Netw Open. 2025;8(6):e2518493.