HMN 2026: How to Treat opioid use disorder with methadone in pharmacies could widen access and turn a profit

University of Rhode Island Clinical Professor of Pharmacy Jeffrey Bratberg partnered with Brandeis University and Boston University researchers in a recent study that found that pharmacy-based methadone dispensing models can operate profitably while widening access—a key step toward reducing overdose deaths.

Bratberg, the sole pharmacist author on the study, provided his experience in addiction care—the use of medications to treat addiction—and community pharmacy research. Given Bratberg’s longstanding relationship with Professor Traci Green, director of the Opioid Policy Research Collaborative at Brandeis, he was invited to contribute to the study, which aims to find ways to increase access to care for underserved people in the nation. Green was the senior author of the paper.

In addition to Bratberg and Green, the research team for the study included: Elena Soranno, an undergraduate research assistant, and Murray Dawson, a graduate research assistant, both at Brandeis; Sage Feltus, a research associate; and Maureen T. Stewart, research associate professor, both at the Boston University School of Public Health.

“We want to increase access to life-saving medication,” said Bratberg, “Our goal is to increase choices for people and to add a choice where people don’t have it.”

The study, published in the March 16 edition of JAMA Network Open, comes as many health care providers and treatment advocates are calling for more widespread availability of medications used to treat opioid use disorder. Nationally, overdose deaths have dropped 26% from 2023 to 2024 and continue to decline nationally, leaving more people living with addiction but largely untreated.

An economic evaluation assessed two separate models that would allow methadone access through pharmacies. By using a “pharmacist-dispensed” model, in which medical professionals prescribe and pharmacists dispense methadone directly, researchers estimated a return of $2.64 per dollar spent for a net profit of $23,844 over three years. Using a pharmacy-based “medication unit” model, in which established opioid treatment program clinicians prescribe methadone and pharmacists dispense it, the study found the estimated return jumped to $3.53 per dollar spent, for a net profit of $96,904 over three years.

“It is a disservice to your patient if you start something and later say ‘I can’t keep doing this because it’s not financially viable,'” said Bratberg. “Pharmacies are struggling financially. If a pharmacy is your only choice for access to a medication and they go out of business, you lose all access to all medications. We don’t have to have that risk.”

The medication unit model is permissible under current law, while the pharmacist-dispensed model is possible with a broadening of the U.S. Drug Enforcement Administration’s regulatory interpretation.

“Patients want it. Pharmacists are trained to do it. Pharmacies exist where patients want it. And now we know this is something that is also feasible and sustainable from a profit and loss perspective,” said Bratberg. “All the ingredients are there to support regulatory change to say ‘hey policymakers, you flip a switch and then we can save lives.'”

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