Virtual OUD Solutions Break Down Barriers to Access and Support Pharmacist Engagement

In this Pharmacy Times interview with Caroline Pearson, executive director at Peterson Health Technology Institute (PHTI), she discusses how virtual opioid use disorder (OUD) solutions can help lower barriers to care by expanding geographic access, offering convenience for working patients, and reducing stigma through increased privacy. Pearson emphasizes that while these platforms are effective, one of their challenges is ensuring patients know they exist. She highlights the critical role pharmacists can play in connecting patients to virtual treatment options, ultimately helping individuals access care that may be preferable to traditional in-person visits.

Pharmacy Times: To start, could you give a brief overview of PHTI’s evaluation of virtual opioid use disorder (OUD) solutions and the key findings?

Caroline Pearson, Executive Director, PHTI: We looked at virtual solutions that are delivering medication-based treatment for opioid use disorder and offering a suite of digital support services. These include therapy, contingency management, and peer support programs that can help people remain in care. We examined the clinical effectiveness of these virtual solutions, and we also looked at the economic impact over a one- to three-year timeframe.

We evaluated two different categories of solutions. The first includes both medication prescribing—typically buprenorphine prescribing via telehealth—and additional support services such as therapy. The second category is digital wraparound solutions, which consist solely of digital support services that can be paired with other medication-based providers to create a more comprehensive set of treatment options.

We focused primarily on retention in treatment, which is the most clinically important outcome because it ensures people remain in care, continue to receive their medications, and are protected against overdose. Generally, we found that these virtual solutions perform as well as traditional medication-based opioid providers, offering comparable or slightly better treatment retention. On average, virtual solutions retain patients in treatment for about 13 more days over a six-month period. In opioid use disorder, every day in treatment counts, and those are meaningful improvements in care. However, given the magnitude of the opioid epidemic and the importance of achieving a lifetime of recovery, we would hope for more than 13 additional days of improved retention.

From an economic perspective, medication-based solutions, because they can be substituted for usual care, are effective at keeping costs equal or slightly reducing them. In contrast, digital wraparound solutions, which are layered on top of usual care, increase spending slightly because they add costs to the system without producing significant health savings from the modest improvements in treatment retention.

In total, we believe there is an important place in the market for growth, particularly of the medication-focused opioid use disorder solutions.

Pharmacy Times: Pharmacists are often one of the most accessible points of care for patients. How can they support or integrate virtual OUD solutions into their practice?

Pearson: One of the great things about virtual OUD solutions is that they can lower some of the barriers to care. They are available across geographies, including in areas where there may not be other treatment providers. They are convenient for people who are working, since they do not require weekly in-person office visits. They can also reduce stigma by improving privacy, as people are able to receive treatment in their own homes, which many value.

For pharmacists, this is particularly important because one of the challenges with virtual solutions is bringing new people into treatment. Although they are convenient, if patients are not aware of them, they may never choose to initiate treatment. Pharmacists who interact with patients who could benefit from care play a key role in making patients aware that virtual solutions exist and may be preferable to in-person options. By offering these as one of the available treatment options, pharmacists can help patients access care that best meets their needs.