Healthcare Costs and Resource Use Among Chronic Low‐Back Pain Patients Treated With Belbuca or Buprenorphine Transdermal Patches: A Retrospective US Medicare Claims Analysis

Objectives: To compare the economic burden of Medicare patients diagnosed with chronic low‐back pain (cLBP) treated with Belbuca (buprenorphine buccal film) or buprenorphine transdermal patches in the US healthcare setting. Methods: This study was performed using Merative MarketScan Medicare claims (2018–2021). Belbuca and buprenorphine patch prescriptions were identified using national drug codes. Patients were observed 6 months before and 6 months after the index date (first prescription of Belbuca or buprenorphine patch). Patients with a gap in insurance coverage, opioid use disorder, or cancer during the observational period were excluded. Switching between cohorts was not allowed. Demographic characteristics were assessed on the index date and clinical characteristics during the preindex period. Propensity‐score matching (PSM) was performed. Results: After PSM, the sample consisted of 124 (44 Belbuca and 80 buprenorphine patch) patients. Belbuca patients had significantly lower total cLBP‐related healthcare costs than transdermal patch patients during the postindex period ($799 vs. $2,273, p = 0.047). Total any‐cause costs were numerically lower in the Belbuca cohort ($12,076 vs. $17,159, p = 0.138), with a statistical significance in outpatient costs ($3766 vs. $5,992, p = 0.031). Belbuca patients also had significantly fewer cLBP‐related outpatient visits (4.2 vs. 6.5 visits, p = 0.003). Healthcare cost trends analysis (6‐month postindex vs. 6‐month preindex) demonstrated stable expenditures after starting Belbuca treatment (all p ≥ 0.050). After initiating buprenorphine patch treatment, significant cost increases were observed in the total any‐cause costs ($6,206, p = 0.002). Between‐cohort comparison of healthcare cost trends showed significant cost savings after starting Belbuca vs. buprenorphine patches regarding the total any‐cause costs (−$851 vs. $6,206, p = 0.019), mainly driven by outpatient (−$1951 vs. $1,320, p = 0.044) and inpatient costs ($58 vs. $5,065, p = 0.039). Conclusion: This study demonstrated lower total cLBP‐related and any‐cause outpatient costs with fewer cLBP‐related outpatient visits and favorable healthcare cost trends in Belbuca as compared with buprenorphine patch patients.