Extended-Release Buprenorphine Not Necessarily Cost-Effective

Extended-release buprenorphine not cost-effective when transmucosal buprenorphine is available for treatment of OUD

By Elana Gotkine HealthDay Reporter

TUESDAY, Sept. 19, 2023 (HealthDay News) — For patients with opioid use disorder (OUD), treatment with extended-release buprenorphine is not cost-effective when transmucosal buprenorphine is available, according to a study published online Sept. 13 in JAMA Network Open.

Juliet M. Flam-Ross, from Boston Medical Center, and colleagues examined the cost-effectiveness of extended-release buprenorphine versus transmucosal buprenorphine. The evaluation simulated the lifetime of a closed cohort of 100,000 individuals with OUD receiving or not receiving opioid agonist treatment with buprenorphine.

The researchers found that treatment with transmucosal buprenorphine yielded an incremental cost-effectiveness ratio of $19,740 per quality-adjusted life year (QALY) compared with no medication treatment. Treatment with extended-release versus transmucosal buprenorphine yielded lower effectiveness by 0.03 QALYs per person at higher cost. Transmucosal buprenorphine was the preferred strategy 60 percent of the time in probabilistic sensitivity analyses. Compared with treatment with transmucosal buprenorphine, treatment with extended-release buprenorphine was cost-effective at a willingness-to-pay threshold of $100,000 per QALY only after substantial changes in key parameters.

“The ongoing nationwide surge in opioid overdose deaths underscores the need for a broad menu of effective treatments to address the diverse needs of all patients,” the authors write. “Our findings on important thresholds in two key parameters, namely cost and retention, might be helpful to policy makers.”

One author disclosed ties to industry.

Abstract/Full Text


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