The effect of British Columbia's Pharmacare coverage expansion for opioid agonist treatment

Natt Hongdilokkul, Emanuel Krebs, Xiao Zang, Haoxuan Zhou, Fahmida Homayra, Jeong Eun Min, Bohdan Nosyk

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Opioid agonist treatment (OAT) is the evidence-based standard of care for people with opioid use disorder. In British Columbia, Canada, only social assistance registrants received full coverage for OAT prior to the introduction of the Pharmacare Plan G coverage expansion on February 1st, 2017. We aimed to determine the effect of the coverage expansion on OAT initiation, re-initiation, and retention. Using linked population-level data, we executed a difference-in-differences analysis to compare outcomes of individuals eligible for the additional coverage and social assistance registrants already receiving the most generous coverage for OAT prior to the policy change, adjusting for individual and prescriber characteristics. We found Plan G coverage expansion significantly increased OAT retention. Specifically, coverage expansion decreased the number of OAT episode discontinuations by 12.8% (95% CI: 8.4%, 17.2%).

Original languageEnglish (US)
Pages (from-to)1222-1238
Number of pages17
JournalHealth Economics (United Kingdom)
Issue number5
StatePublished - May 2021
Externally publishedYes

Bibliographical note

Funding Information:
This work was sponsored by the Health Canada Substance Use and Addictions Program Grant No. 1819-HQ-000036. All inferences, opinions, and conclusions drawn in this manuscript are those of the authors, and do not reflect the opinions or policies of the British Columbia Ministry of Health and the Data Steward(s).

Publisher Copyright:
© 2021 John Wiley & Sons Ltd.


  • insurance
  • opioid agonist treatment
  • opioid use disorder
  • public health
  • substance abuse
  • treatment retention


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