Prior Authorization Requirement for Suboxone Coverage Impedes Recovery: Expert

Many insurance companies require patients who have been prescribed the opioid addiction treatment Suboxone to get prior authorization, NPR reports. This requirement can take days or weeks, leaving patients vulnerable to relapse, one expert says.

Sam Muszynski, Director of Health Care Systems and Financing at the American Psychiatric Association, said, “You may lose that opportunity right then and there. They may never come back.”

Medicaid required a prior authorization for buprenorphine, the active ingredient in Suboxone, in 48 states in 2013.

“It’s almost like when you take on a patient to treat opiate addiction, you also have to take on another patient called the insurance company,” said Dr. Andrew Chambers, a psychiatrist and addiction specialist in Indianapolis.