Virginia Eases Suboxone-Prescribing Restrictions

By Paul Gaita 03/20/19

The policy change will increase access to the medication and reduce delays in treatment.

pharmacist filling Suboxone prescription

Prior authorization will no longer be required for Virginia physicians to prescribe a form of the opioid addiction medication, Suboxone, to patients.

The state's Department of Medical Assistance Services (DMAS), which oversees the Virginia Medicaid program, has removed the authorization requirement for  Suboxone film (a film applied to the tongue). Suboxone is a brand of buprenorphine that assists individuals in reducing or quitting their dependencies on heroin or prescription opioids.

Acting chief medical officer of the DMAS, Dr. Chethan Bachireddy, said in a press release that his agency has "a responsibility to understand and to meet the needs of our members and the providers who treat them."

Before the policy change, Virginia physicians were required to obtain prior authorization from DMAS or one of its contracted health plans to prescribe Suboxone film.

According to the Virginia Mercury, the change will increase access to the medication and reduce delays in treatment.

The Virginia Mercury also cited a recent study by Virginia Commonwealth University that found that the expansion of Medicaid—approved by voters in 2018—will provide as many as 60,000 uninsured Virginians with access to treatment services for dependency issues, including 18,000 with opioid dependency.

In all, 400,000 Virginia residents are expected to gain access to coverage in 2019.

Data culled from the office of the state's chief medical examiner in January 2019 found that 1,229 Old Dominion residents died as a result of opioid-related overdose in 2018—the same number of fatalities that occurred in 2017. However, the total number of 2018 fatalities will not be available until this spring.

The revision of the authorization requirement applies only to Suboxone film, but not to other forms of buprenorphine that are not on the Medicaid preferred drugs list.

But buprenorphine, often in conjunction with counseling, has proven to be effective in lowering death rates among those who have suffered a previous overdose. The DMAS press release cited a study that suggested that among overdose survivors, there was a 40% decrease in the death rate of those who used Suboxone, compared to those who did not.

Bachireddy described the revision as one of several "effective, proactive strategies that are putting Virginia at the forefront in the fight against the opioid crisis."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.