Table 4.
Predictors of Mean Daily Dosage (Milligrams/Day) for Buprenorphine-Naloxone Treatment
| Mean Daily Dosage | ||||
|---|---|---|---|---|
| Adj. Mean | Coeff. | 95% CI | p-value | |
| Female | 14.0 | −0.17 | (−0.31--0.02) | 0.023 |
| Age (Ref=18–34) | 13.9 | |||
| Age 35–49 | 14.3 | 0.4 | (0.2–0.59) | <.001 |
| Age >50 | 13.7 | −0.18 | (−0.41–0.06) | 0.14 |
| Majority Payer (Ref=Cash) | 13.1 | |||
| Medicaid Fee-for-service | 14.5 | 1.37 | (0.96–1.78) | <.001 |
| Medicare Part D | 14.2 | 1.14 | (0.77–1.51) | <.001 |
| Third-Party Commercial | 13.5 | 0.41 | (0.18–0.63) | <.001 |
| Majority Prescriber (Ref=PCP) | 14.6 | |||
| Psychiatrist | 13.8 | −0.77 | (−1.17−−0.38) | <.001 |
| Other provider | 14.2 | −0.38 | (−0.74−−0.03) | 0.035 |
| Metropolitan Status (Ref=nonmetro) | 14.2 | |||
| Large (>1 million people) | 14.4 | 0.2 | (−0.31–0.71) | 0.433 |
| Medium (>250k-1 million people) | 14.4 | 0.2 | (−0.33–0.74) | 0.452 |
| Small (100k-250k people) | 14.5 | 0.33 | (−0.31–0.96) | 0.317 |
| County opioid overdose death rate (Ref=>18.1 per 100,000) | 14.2 | |||
| ≤10 deaths per 100k | 14.4 | 0.29 | (−0.42–1) | 0.428 |
| 10.1–14 deaths per 100k | 13.9 | −0.31 | (−0.85–0.23) | 0.263 |
| 14.1–17.9 deaths per 100k | 14.1 | −0.07 | (−0.54–0.4) | 0.78 |
| Other county covariates | ||||
| Crossed county lines for treatment | 14.2 | 0.07 | (−0.2–0.33) | 0.626 |
| PCP to population ratio (standardized) | 14.2 | 0.12 | (−0.05–0.28) | 0.176 |
| DEA waivered ratio (standardized) | 14.1 | −0.04 | (−0.2–0.13) | 0.658 |
| Median income (standardized) | 13.7 | −0.43 | (−0.62−−0.23) | <.001 |
| Non-minority pop. (standardized) | 14.4 | 0.3 | (−0.01–0.61) | 0.058 |
| State of Pharmacy (Ref=Arizona) | 12.4 | |||
| California | 12.6 | 0.17 | (−0.71–1.04) | 0.706 |
| Florida | 13.2 | 0.82 | (−0.02–1.67) | 0.056 |
| Georgia | 14.1 | 1.68 | (0.76–2.61) | <.001 |
| Louisiana | 15.1 | 2.71 | (1.77–3.65) | <.001 |
| Maryland | 14.2 | 1.84 | (0.97–2.7) | <.001 |
| New Jersey | 14.0 | 1.59 | (0.45–2.72) | 0.006 |
| New York | 13.7 | 1.19 | (0.2–2.18) | 0.018 |
| Pennsylvania | 14.8 | 2.4 | (1.36–3.43) | <.001 |
| Texas | 13.0 | 0.58 | (−0.24–1.39) | 0.166 |
| Washington | 13.6 | 1.11 | (0.22–2) | 0.015 |
| Other states | 14.2 | 1.76 | (0.93–2.59) | <.001 |
NOTES: Authors’ analysis of the IMS LifeLink database (N=27,235 individuals initiating first episodes of buprenorphine-naloxone treatment in 2010–2012). Estimates are derived from ordinary least squares regression models and adjusted means represent the predicted value holding all other variables constant at their mean. Standard errors are clustered in both models at the county level. Standardized coefficients represent the marginal difference associated with a 1-standard deviation increase in the predictor variable.