MDDCSAM and ASAM Express Concerns Regarding Denials for Buprenorphine to Treat OUD

On November 17th, the Maryland-DC Society of Addiction Society of Addiction Medicine (MDDCSAM) and the American Society of Addiction Medicine (ASAM) sent a letter to Amerigroup DC expressing concerns with a recent pattern of prior authorization (PA) denials of buprenorphine prescriptions for opioid use disorder (OUD). Specifically, these denials have occurred in the Washington, DC area as overdose deaths increase. 

In the letter, MDDCSAM and ASAM expressed their shared concern regarding rising opioid-related overdose deaths in Washington, DC, attributed primarily to high-potency synthetic opioids (HPSOs), including fentanyl and its analogs. Further, MDDCSAM and ASAM sought to notify Amerigroup DC of ASAM’s new clinical consideration document for the treatment of opioid use disorder (OUD) with buprenorphine. These clinical considerations highlight recent evidence indicating that higher dose (> 16 mg per day) buprenorphine treatment may be beneficial to reduce withdrawal symptoms and increase treatment retention in the era HPSOs. Finally, the letter urged Amerigroup DC to revisit its utilization management policies governing buprenorphine dosing in response to this pattern of denials.

Read the letter here.