State X-waiver Statutes and Buprenorphine Prescriber Rates Following Federal X-waiver Elimination, 2021-2023.

Cohort studyAmerican journal of preventive medicine· Jul 2026

State X-waiver Statutes and Buprenorphine Prescriber Rates Following Federal X-waiver Elimination, 2021-2023.

Filmon Wolde, Bradley C Martin, Mahip Acharya … Corey J Hayes

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Addiction MedicineCohort studyClinical practiceQ1IF 4.3

Removing X-waiver statutes was not linked to higher buprenorphine prescriber rates.

State X-waiver Statutes and Buprenorphine Prescriber Rates Following Federal X-waiver Elimination, 2021-2023.

Filmon Wolde … Corey J Hayes

American journal of preventive medicine · Jul 2026 · Q1 in Public Health

Background

This study examined whether U.

Methods

Using a 25% random sample from IQVIA PharMetrics® Plus for Academics, data from January 2021-October 2023 (analyzed from 2025-2026) were modeled using Comparative Interrupted Time Series (Comparative Interrupted Time Series) models of monthly rates of unique buprenorphine prescribers per 10,000 eligible prescribers and jurisdiction fixed-effects generalized estimating equations (generalized estimating equations).

n = Forty-nine jurisdictions and 1,558

Results

no clear difference in buprenorphine prescriber rates with or without X-waiver language

96.84prescr

With X-waiver referenc

47.01prescr

Without X-waiver refer

More results

Mean buprenorphine prescriber rates were higher in jurisdictions with X-waiver references than without (96.84 vs 47.01 buprenorphine prescribers/10,000 eligible prescribers).

Findings were consistent across strata and sensitivity analyses.

“

Conclusion

Findings suggest that removing jurisdiction-level statutory X-waiver references is unlikely to expand access, as structural barriers persist.

State X-waiver Statutes and Buprenorphine Prescriber Rates Following Federal X-waiver Elimination, 2021-2023.

State X-waiver Statutes and Buprenorphine Prescriber Rates Following Federal X-waiver Elimination, 2021-2023.

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