Dottie's Specialty Pharmacy: Adherence, Persistence, and Measurable System Impact in Long-Acting Injectable Treatment for Opioid Use Disorder

This executive summary examines the relationship between adherence to long-acting injectable (LAI) medications for opioid use disorder (OUD) and measurable clinical and system-level outcomes. LAIs – including extended-release buprenorphine (Sublocade, Brixadi) and extended-release naltrexone (Vivitrol) – are designed to provide continuous pharmacologic coverage and reduce relapse risk associated with treatment gaps. In 2025, Dottie’s Pharmacy reported that 80% of patients achieved at least 80% proportion of days covered (PDC), 45% reached 95% PDC, and 35% remained on therapy for four months or longer. Published evidence links sustained medication exposure with reduced overdose mortality, fewer emergency department visits, lower inpatient utilization, and decreased healthcare spending. With overdose events generating significant short-term costs and contributing to billions in annual hospital expenditures, adherence and persistence function not only as clinical quality indicators but also as markers of broader health system impact.

Download the full report here.