Health Policy Statistics Section Lunchtime Speaker (Added Fee)

Buprenorphine treatment for opioid use disorder (OUD) is highly effective and improves pregnancy outcomes. Dr. Patrick's team at Vanderbilt and Emory universities used a secret shopper approach to assess access to treatment in these women.

A market research lab hired women to contact physicians for an appointment. These women (callers) had profiles claiming to either be, or not be, pregnant and to have Medicaid or private insurance. 10,117 profiles were randomly assigned to 5,944 physicians from 10 states balanced on profiles and state. Callers used scripts that were developed and field tested in non-study states. Data collected included the ability to get an appointment, waiting time for an appointment, and out of pocket costs. Statistical methods included a mixed effects logistic regression model.

Pregnant callers were less likely to receive an appointment (61%) vs. non-pregnant callers (74%); relative risk 0.83; 95% CI, 0.79-0.87. 26% of callers did not have their insurance accepted. Among cash paying callers the median out-of-pocket costs for the initial appointment was $250 (interquartile range $155-$300).
Failure to treat pregnant women with OUD is tragic and costly.