TY - JOUR
KW - Buprenorphine/economics/therapeutic use
KW - Cost-Benefit Analysis
KW - Crime/economics
KW - HIV Infections/economics/epidemiology
KW - Health Services/economics/utilization
KW - Hepatitis C/economics/epidemiology
KW - Humans
KW - Markov Chains
KW - Methadone/economics/therapeutic use
KW - Models, Economic
KW - Narcotic Antagonists/economics/therapeutic use
KW - Opiate Substitution Treatment/economics/methods
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - Quality-Adjusted Life Years
KW - United Kingdom
KW - opioid dependence
KW - economic evaluation
KW - opioid use disorder
KW - pharmacologic (drug) maintenance therapy
KW - societal costs
AU - J. Kenworthy
AU - Y. Yi
AU - A. Wright
AU - J. Brown
AU - Maria Madrigal
AU - W. C. N. Dunlop
A1 - 
AB - AIMS: This study investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) vs no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over 1 year. METHODS: Cost-effectiveness of OST vs no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model. The expanded model included the impact of OST on infection rates of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. RESULTS: Versus no OST, incremental cost-effectiveness ratios (ICERs) for BMT and MMT were pound13,923 and pound14,206 per quality-adjusted life year (QALY), respectively, from a NHS/PSS perspective. When total costs (NHS/PSS and societal) are considered, there are substantial savings associated with adopting OST; these savings are in excess of pound14,032 for BMT vs no OST and pound17,174 for MMT vs no OST over 1 year. This is primarily driven by a reduction in victim costs. OST treatment also impacted other aspects of criminality and healthcare resource use. LIMITATIONS: The model's 1-year timeframe means long-term costs and benefits, and the influence of changes over time are not captured. CONCLUSIONS: OST can be considered cost-effective vs no OST from the UK NHS/PSS perspective, with a cost per QALY well below the UK's willingness-to-pay threshold. There were only small differences between BMT and MMT. The availability of two or more cost-effective options is beneficial to retaining patients in OST programs. From a societal perspective, OST is estimated to save over pound14,032 and pound17,174 per year for BMT and MMT vs no OST, respectively, due to savings in victim costs. Further work is required to fully quantify the clinical and health economic impacts of different OST formulations and their societal impact over the long-term.
AD - a Mundipharma International Limited , Cambridge , UK.; b PHMR , London , UK.; b PHMR , London , UK.; b PHMR , London , UK.; b PHMR , London , UK.; a Mundipharma International Limited , Cambridge , UK.
BT - Journal of medical economics
C5 - Financing & Sustainability; Opioids & Substance Use
CP - 7
CY - England
DO - 10.1080/13696998.2017.1325744
IS - 7
JF - Journal of medical economics
M1 - Journal Article
N2 - AIMS: This study investigated the cost-effectiveness of buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT) vs no opioid substitution therapy (OST) for the treatment of opioid use disorder, from the UK National Health Service (NHS)/personal social services (PSS) and societal perspectives over 1 year. METHODS: Cost-effectiveness of OST vs no OST was evaluated by first replicating and then expanding an existing UK health technology assessment model. The expanded model included the impact of OST on infection rates of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. RESULTS: Versus no OST, incremental cost-effectiveness ratios (ICERs) for BMT and MMT were pound13,923 and pound14,206 per quality-adjusted life year (QALY), respectively, from a NHS/PSS perspective. When total costs (NHS/PSS and societal) are considered, there are substantial savings associated with adopting OST; these savings are in excess of pound14,032 for BMT vs no OST and pound17,174 for MMT vs no OST over 1 year. This is primarily driven by a reduction in victim costs. OST treatment also impacted other aspects of criminality and healthcare resource use. LIMITATIONS: The model's 1-year timeframe means long-term costs and benefits, and the influence of changes over time are not captured. CONCLUSIONS: OST can be considered cost-effective vs no OST from the UK NHS/PSS perspective, with a cost per QALY well below the UK's willingness-to-pay threshold. There were only small differences between BMT and MMT. The availability of two or more cost-effective options is beneficial to retaining patients in OST programs. From a societal perspective, OST is estimated to save over pound14,032 and pound17,174 per year for BMT and MMT vs no OST, respectively, due to savings in victim costs. Further work is required to fully quantify the clinical and health economic impacts of different OST formulations and their societal impact over the long-term.
PP - England
PY - 2017
SN - 1941-837X; 1369-6998
SP - 740
EP - 748
EP - 
T1 - Use of opioid substitution therapies in the treatment of opioid use disorder: results of a UK cost-effectiveness modelling study
T2 - Journal of medical economics
TI - Use of opioid substitution therapies in the treatment of opioid use disorder: results of a UK cost-effectiveness modelling study
U1 - Financing & Sustainability; Opioids & Substance Use
U2 - 28489467
U3 - 10.1080/13696998.2017.1325744
VL - 20
VO - 1941-837X; 1369-6998
Y1 - 2017
Y2 - Jul
ER -