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Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial.
Addiction 2010; 105(9):1616-24A

Abstract

AIMS

The objective is to estimate cost, net social cost and cost-effectiveness in a clinical trial of extended buprenorphine-naloxone (BUP) treatment versus brief detoxification treatment in opioid-dependent youth.

DESIGN

Economic evaluation of a clinical trial conducted at six community out-patient treatment programs from July 2003 to December 2006, who were randomized to 12 weeks of BUP or a 14-day taper (DETOX). BUP patients were prescribed up to 24 mg per day for 9 weeks and then tapered to zero at the end of week 12. DETOX patients were prescribed up to 14 mg per day and then tapered to zero on day 14. All were offered twice-weekly drug counseling.

PARTICIPANTS

152 patients aged 15-21 years.

MEASUREMENTS

Data were collected prospectively during the 12-week treatment and at follow-up interviews at months 6, 9 and 12.

FINDINGS

The 12-week out-patient study treatment cost was $1514 (P < 0.001) higher for BUP relative to DETOX. One-year total direct medical cost was only $83 higher for BUP (P = 0.97). The cost-effectiveness ratio of BUP relative to DETOX was $1376 in terms of 1-year direct medical cost per quality-adjusted life year (QALY) and $25,049 in terms of out-patient treatment program cost per QALY. The acceptability curve suggests that the cost-effectiveness ratio of BUP relative to DETOX has an 86% chance of being accepted as cost-effective for a threshold of $100,000 per QALY.

CONCLUSIONS

Extended BUP treatment relative to brief detoxification is cost effective in the US health-care system for the outpatient treatment of opioid-dependent youth.

Authors+Show Affiliations

PENN Medicine and the Wharton School, University of Pennsylvania, Blockley Hall, Philadelphia, PA 19104, USA. polsky@mail.med.upenn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20626379

Citation

Polsky, Daniel, et al. "Cost-effectiveness of Extended Buprenorphine-naloxone Treatment for Opioid-dependent Youth: Data From a Randomized Trial." Addiction (Abingdon, England), vol. 105, no. 9, 2010, pp. 1616-24.
Polsky D, Glick HA, Yang J, et al. Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial. Addiction. 2010;105(9):1616-24.
Polsky, D., Glick, H. A., Yang, J., Subramaniam, G. A., Poole, S. A., & Woody, G. E. (2010). Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial. Addiction (Abingdon, England), 105(9), pp. 1616-24. doi:10.1111/j.1360-0443.2010.03001.x.
Polsky D, et al. Cost-effectiveness of Extended Buprenorphine-naloxone Treatment for Opioid-dependent Youth: Data From a Randomized Trial. Addiction. 2010;105(9):1616-24. PubMed PMID: 20626379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial. AU - Polsky,Daniel, AU - Glick,Henry A, AU - Yang,Jianing, AU - Subramaniam,Geetha A, AU - Poole,Sabrina A, AU - Woody,George E, Y1 - 2010/07/12/ PY - 2010/7/15/entrez PY - 2010/7/16/pubmed PY - 2011/3/30/medline SP - 1616 EP - 24 JF - Addiction (Abingdon, England) JO - Addiction VL - 105 IS - 9 N2 - AIMS: The objective is to estimate cost, net social cost and cost-effectiveness in a clinical trial of extended buprenorphine-naloxone (BUP) treatment versus brief detoxification treatment in opioid-dependent youth. DESIGN: Economic evaluation of a clinical trial conducted at six community out-patient treatment programs from July 2003 to December 2006, who were randomized to 12 weeks of BUP or a 14-day taper (DETOX). BUP patients were prescribed up to 24 mg per day for 9 weeks and then tapered to zero at the end of week 12. DETOX patients were prescribed up to 14 mg per day and then tapered to zero on day 14. All were offered twice-weekly drug counseling. PARTICIPANTS: 152 patients aged 15-21 years. MEASUREMENTS: Data were collected prospectively during the 12-week treatment and at follow-up interviews at months 6, 9 and 12. FINDINGS: The 12-week out-patient study treatment cost was $1514 (P < 0.001) higher for BUP relative to DETOX. One-year total direct medical cost was only $83 higher for BUP (P = 0.97). The cost-effectiveness ratio of BUP relative to DETOX was $1376 in terms of 1-year direct medical cost per quality-adjusted life year (QALY) and $25,049 in terms of out-patient treatment program cost per QALY. The acceptability curve suggests that the cost-effectiveness ratio of BUP relative to DETOX has an 86% chance of being accepted as cost-effective for a threshold of $100,000 per QALY. CONCLUSIONS: Extended BUP treatment relative to brief detoxification is cost effective in the US health-care system for the outpatient treatment of opioid-dependent youth. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/20626379/Cost_effectiveness_of_extended_buprenorphine_naloxone_treatment_for_opioid_dependent_youth:_data_from_a_randomized_trial_ L2 - https://doi.org/10.1111/j.1360-0443.2010.03001.x DB - PRIME DP - Unbound Medicine ER -