JAMA Health Forum

State bans on prior authorization fall short on improving buprenorphine retention

March 11, 2026

A cross-sectional study found that state laws prohibiting prior authorization for buprenorphine didn’t meaningfully improve 180‑day treatment retention among privately insured adults, with fewer than one third of roughly 23,000 new treatment initiators remaining on therapy for at least 180 days without >7‑day gaps. Retention rates were similar regardless of whether states had enacted prior authorization prohibitions, and even when researchers allowed for longer gaps between prescriptions, fewer than half of patients (45.7%) stayed in treatment without interruptions >30 days.

Clinical takeaway: Clinicians should anticipate continued adherence barriers and reinforce support strategies such as frequent follow-up, minimizing treatment interruptions, and addressing administrative or behavioral hurdles.

Sources:

Hu JC, et al. (2026, March 6). JAMA Health Forum. State Prior Authorization Prohibitions and Buprenorphine Retention Among Privately Insured Patients. https://pubmed.ncbi.nlm.nih.gov/41790453/

(2026, March 6). Weill Cornell Medicine. Prior Authorization Bans for Buprenorphine Alone May Not Improve Treatment Retention [News release]. https://news.weill.cornell.edu/news/2026/03/prior-authorization-bans-for-buprenorphine-alone-may-not-improve-treatment-retention