Overdose Measures Matter

Indicator Profile

Number of medications for opioid use disorder (MOUD) prescriptions filled

Category: Linkage to Care

Audience: Convener

Data Type: Quantitative

Indicator Overview

Description:

Total number of medications for opioid use disorder (MOUD) prescriptions filled

Rationale:

Medications for opioid use disorder (MOUD) are a safe and effective treatment for opioid use disorder (OUD).1,2 MOUD can help people reduce or stop their opioid use, reduce symptoms related to OUD and reduce the risk of opioid overdose.3 However, not everyone with OUD has access to these medications.4

Monitoring the number of MOUD prescriptions filled provides insight into MOUD access. Examining the number of prescriptions by patient race, insurance status and age group increases our understanding of how access to MOUD may vary by population. Large differences in prescription rates may reveal gaps in access to MOUD or highlight specific barriers among certain groups that may be addressed through tailored interventions and efforts to expand local treatment capacity.

Note: This indicator measures only one of many components of the broader “cascade of care” framework. This framework is used to illustrate how patients progress through the different stages of treatment OUD, starting from the initial diagnosis through recovery. For a more comprehensive assessment of OUD treatment in your jurisdiction, see the suggested Related Indicators developed by our partners.

Related Indicators:

Additional indicators to assess treatment for OUD have been developed by our partners and are currently available online:

Pew Charitable Trusts: Core OUD Treatment Measures

Pew Charitable Trusts developed a set of Core Opioid Use Disorder (OUD) Treatment Measures that states can use to assess treatment system effectiveness. Utilizing a measurement framework known as the OUD “cascade of care,” users can track services from diagnosis to recovery. The selected measures are organized by stages of the cascade. More details are available on Pew Charitable Trusts' website.

Johns Hopkins Bloomberg School of Public Health: Opioid Settlement Principles Resource and Indicators

Vital Strategies and the Johns Hopkins Bloomberg School of Public Health developed an online interactive tool, the Opioid Settlement Principles Resource and Indicators (OSPRI). OSPRI aims to guide counties and states in investing in effective overdose prevention strategies using opioid settlement dollars. From the OSPRI tool, select strategy #2 – “Increase use of medications to treat opioid use disorder” to find related indicators.

Centers for Disease Control and Prevention

CDC developed a standardized set of linkage to care surveillance indicators for the Overdose Data to Action (OD2A) program. These indicators follow the cascade of care model for substance use disorders. This publication describes the process for developing these indicators and how they may be used to monitor and improve linkage to care efforts at the state and local level.

Indicator Details

Definitions:

Medications for opioid use disorder (MOUD) includes the three medications that have been approved by the FDA to treat OUD: buprenorphine, methadone and naltrexone.2

Select a timeframe that is most relevant and feasible to you (e.g., monthly, annually) given the data that is most accessible.

Ways to Examine the Data:

  1. Participant demographics (e.g., race, ethnicity, sex, insurance status, age group)
  2. Type of MOUD (e.g., methadone, buprenorphine, naltrexone)

Data Sources:

  • Electronic health records (EHR) from medical providers, healthcare organizations, medical institutions or hospitals
  • Insurance claims data from the Centers for Medicare and Medicaid Services (CMS) database (for claims data filed through Medicaid) or All-Payer Claims database (claims data from both private and public insurance that are maintained by the state)

Note: All-Payer Claims databases may not be available for all states

Data Collection Methods:

  • EHR data are collected and maintained by the medical provider or institution. To access these data consider partnering with healthcare organizations, medical institutions or hospital systems.
  • Claims data are collected and maintained by insurance payers. To access these data consider partnering with regional managed care organizations or state/local government departments that are responsible for managing publicly funded SUD treatment.

Application and Considerations

Suggested Use:

  • To use as a proxy for MOUD utilization
  • To identify potential differences in MOUD access by population groups; to identify access gaps
  • To improve access to MOUD

Health Access Considerations:

You may want to consider:

  • Are patients being offered all forms of FDA-approved MOUD?
  • How are priority populations able to access MOUD? For example, people who are incarcerated, experiencing homelessness, who do not have health insurance?
  • How many MOUD providers are there in your jurisdiction? Do they treat Medicare or Medicaid enrollees?

Evaluation Considerations:

Limitations:

  • Does not assess retention
  • Does not assess outcomes
  • Does not assess what proportion of people with OUD are receiving MOUD or not receiving MOUD
  • Does not examine barriers to access
  • Data may be an undercount (e.g., certain patient populations may not be captured in available dataset; MOUD may not be captured by insurance claims data)
  • Accessing data may be challenging
  • Data source may not include demographic information or contain inaccurate demographic information

Policy Considerations and Resources:

Additional Resources

Examples:

References:

  1. Centers for Disease Control and Prevention. (2024). Treatment of Opioid Use Disorder.
    https://www.cdc.gov/overdose-prevention/treatment/opioid-use-disorder.html
  2. U.S. Food & Drug Administration. (2024). Information about Medications for Opioid Use Disorder (MOUD).
    https://www.fda.gov/drugs/information-drug-class/information-about-medications-opioid-use-disorder-moud
  3. Substance Abuse and Mental Health Services Administration. (2021). Treatment Improvement Protocol (TIP) 63: Medications for Opioid Use Disorder for Healthcare and Addiction Professionals, Policymakers, Patients and Families. Substance Abuse and Mental Health Services, Department of Health and Human Services.
    https://store.samhsa.gov/sites/default/files/pep21-02-01-002.pdf
  4. Centers for Disease Control and Prevention. (2022). Linking People With Opioid Use Disorder to Medication Treatment: A Technical Package of Policy, Programs and Practices. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, US Department of Health and Human Services.
    https://stacks.cdc.gov/view/cdc/119464