Little is known about the degree to which evidence-based buprenorphine therapy is being accessed consistently and equitably by pregnant and postpartum women with opioid use disorder (OUD). The objective of this study is to analyze prescription claims from a national commercial insurance database to 1) characterize buprenorphine therapy initiation, persistence, and adherence among pregnant and postpartum women with OUD and 2) assess differences in buprenorphine OUD treatment characteristics among rural and urban pregnant/postpartum women.

A retrospective longitudinal analysis of commercial insurance enrollees with live births between 2014 and 2018 and an OUD diagnosis will be conducted via a query of the IBM® MarketScan® Commercial and Medicare Supplemental Research Database. Buprenorphine prescription claims will be evaluated for the evidence-based treatment characteristics of initiation, persistence, and adherence during the 52 weeks comprising pregnancy and the postpartum period. Rural/urban stratification will occur using the metropolitan statistical area associated with claims, where metropolitan is classified as urban and all other designations are classified as rural.

Through characterization of OUD treatment among a large population of women of childbearing age in the U.S. and exploration of rural/urban differences in treatment, this research has potential to inform clinical and public health policy initiatives to promote evidence-based, equitable management of OUD during and immediately after pregnancy.