In this comparative effectiveness study, we used comprehensive insurance claims (ie, all paid services, including outpatient, inpatient, and pharmacy) from the IBM MarketScan Commercial and Multi-State Medicaid Databases from January 1, 2011, until December 31, 2016. Details on methods of data extraction have previously been described.13 Our analytic sample was derived from cohort of 206 909 individuals in the US aged 12 to 64 years with a primary OUD diagnosis and no previous methadone treatment, defined by International Classification of Diseases, Ninth Revision (ICD-9) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, who had at least 1 period of continuous insurance enrollment and corresponding treatment claim for 1 of the following: buprenorphine, extended-release (ER) naltrexone, oral naltrexone, or psychosocial treatment without MOUD. Each period of continuous insurance coverage ended when there was no claim for at least 45 days following the last dose of the most recent prescription assumed to be used. We subsequently limited our sample to 179 280 individuals who had a primary diagnosis of OUD and restricted the years of observation
