TY - JOUR
KW - Adult
KW - Buprenorphine/economics/therapeutic use
KW - Cohort Studies
KW - Combined Modality Therapy/economics
KW - Commerce/economics
KW - Cost of Illness
KW - Counseling/economics
KW - Delivery of Health Care, Integrated/economics/utilization
KW - Female
KW - Health Care Costs/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Opioid-Related Disorders/economics/rehabilitation
KW - Retrospective Studies
KW - United States
KW - Utilization Review
AU - F. L. Lynch
AU - D. McCarty
AU - J. Mertens
AU - N. A. Perrin
AU - C. A. Green
AU - S. Parthasarathy
AU - J. F. Dickerson
AU - B. M. Anderson
AU - D. Pating
A1 - 
AB - BACKGROUND: When used in general medical practices, buprenorphine is an effective treatment for opioid dependence, yet little is known about how use of buprenorphine affects the utilization and cost of health care in commercial health systems. METHODS: The objective of this retrospective cohort study was to examine how buprenorphine affects patterns of medical care, addiction medicine services, and costs from the health system perspective. Individuals with two or more opioid-dependence diagnoses per year, in two large health systems (System A: n = 1836; System B: n = 4204) over the time span 2007-2008 were included. Propensity scores were used to help adjust for group differences. RESULTS: Patients receiving buprenorphine plus addiction counseling had significantly lower total health care costs than patients with little or no addiction treatment (mean health care costs with buprenorphine treatment = $13,578; vs. mean health care costs with no addiction treatment = $31,055; p < .0001), while those receiving buprenorphine plus addiction counseling and those with addiction counseling only did not differ significantly in total health care costs (mean costs with counseling only: $17,017; p = .5897). In comparison to patients receiving buprenorphine plus counseling, those with little or no addiction treatment had significantly greater use of primary care (p < .001), other medical visits (p = .001), and emergency services (p = .020). Patients with counseling only (compared to patients with buprenorphine plus counseling) used less inpatient detoxification (p < .001), and had significantly more PC visits (p = .001), other medical visits (p = .005), and mental health visits (p = .002). CONCLUSIONS: Buprenorphine is a viable alternative to other treatment approaches for opioid dependence in commercial integrated health systems, with total costs of health care similar to abstinence-based counseling. Patients with buprenorphine plus counseling had reduced use of general medical services compared to the alternatives.
BT - Addiction science & clinical practice
C5 - Financing & Sustainability
CY - England
DO - 10.1186/1940-0640-9-16
JF - Addiction science & clinical practice
N2 - BACKGROUND: When used in general medical practices, buprenorphine is an effective treatment for opioid dependence, yet little is known about how use of buprenorphine affects the utilization and cost of health care in commercial health systems. METHODS: The objective of this retrospective cohort study was to examine how buprenorphine affects patterns of medical care, addiction medicine services, and costs from the health system perspective. Individuals with two or more opioid-dependence diagnoses per year, in two large health systems (System A: n = 1836; System B: n = 4204) over the time span 2007-2008 were included. Propensity scores were used to help adjust for group differences. RESULTS: Patients receiving buprenorphine plus addiction counseling had significantly lower total health care costs than patients with little or no addiction treatment (mean health care costs with buprenorphine treatment = $13,578; vs. mean health care costs with no addiction treatment = $31,055; p < .0001), while those receiving buprenorphine plus addiction counseling and those with addiction counseling only did not differ significantly in total health care costs (mean costs with counseling only: $17,017; p = .5897). In comparison to patients receiving buprenorphine plus counseling, those with little or no addiction treatment had significantly greater use of primary care (p < .001), other medical visits (p = .001), and emergency services (p = .020). Patients with counseling only (compared to patients with buprenorphine plus counseling) used less inpatient detoxification (p < .001), and had significantly more PC visits (p = .001), other medical visits (p = .005), and mental health visits (p = .002). CONCLUSIONS: Buprenorphine is a viable alternative to other treatment approaches for opioid dependence in commercial integrated health systems, with total costs of health care similar to abstinence-based counseling. Patients with buprenorphine plus counseling had reduced use of general medical services compared to the alternatives.
PP - England
PY - 2014
SN - 1940-0640; 1940-0632
SP - 16
T1 - Costs of care for persons with opioid dependence in commercial integrated health systems
T2 - Addiction science & clinical practice
TI - Costs of care for persons with opioid dependence in commercial integrated health systems
U1 - Financing & Sustainability
U2 - 25123823
U3 - 10.1186/1940-0640-9-16
VL - 9
VO - 1940-0640; 1940-0632
Y1 - 2014
ER -