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Article History

Accepted: 11 December 2025

First Online: 24 December 2025

Declarations

:

: Dr. Bentley received grants or contracts from the NIH – National Institute on Drug Abuse and the Mississippi State Department of Health, and consulting fees from the Pharmacy Quality Alliance (all outside the submitted work). Dr. Yang received grants from the NIH – National Institute on Drug Abuse outside the submitted work. Dr. Bhattacharya received grants or contracts from the NIH – National Institute on Drug Abuse and the Mississippi State Department of Health outside the submitted work. Dr. Ramachandran received grants or contracts from the NIH – National Institute on Drug Abuse and the Mississippi State Department of Health, and consulting fees from the Pharmacy Quality Alliance (all outside the submitted work). The remaining authors report no conflicts of interest.

: No informed consent was needed because this study used existing, fully de-identified Medicare administrative claims data. The study protocol has been approved by the University of Mississippi (UM) Institutional Review Board (IRB) (protocol no. 24x-107). Data used in this study were provided under a Data Use Agreement (DUA) with the Centers for Medicare and Medicaid Services (CMS) (DUA no. RSCH-2023-59140).

: Not Applicable.

: The data for this study were made available under a data use agreement (DUA) with the Centers for Medicare and Medicaid Services (CMS) (DUA no. RSCH-2023-59140) and cannot be shared publicly. However, data can be accessed, subject to approval and a DUA, from the CMS ( ).

: Statistical programming codes were developed by the author team using SAS software and will be made available from the first author (YH) upon reasonable request.

: Huang had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Huang, Bazzazzadehgan, Lin, Ghodke, and Bruera. Acquisition of data: Yang, Bentley, Ramachandran, and Bhattacharya. Analysis and interpretation of data: Huang, Bazzazzadehgan, Lin, and Bentley. Drafting of the manuscript: Huang. Statistical analysis: Bazzazzadehgan, Huang, and Lin. Administrative, technical, or material support: Yang and Bentley. Supervision: Yang and Bentley. All authors were involved in revising the manuscript critically for important intellectual content and all authors read and approved the final version to be published.

: Part of the work has been presented as a poster presentation at the International Society for Pharmacoeconomics and Outcome Research (ISPOR) Annual Conference in May 2024.