The following is a summary of “Cost-effectiveness of office-based buprenorphine treatment for opioid use disorder,” published in the February 2023 issue of Drug and Alcohol Dependence by Qian et al.

To evaluate the efficacy and cost-effectiveness of office-based buprenorphine treatment (OBBT) in the United States. A model-based analysis was conducted on administering buprenorphine treatment in a primary care setting for individuals in the United States diagnosed with opioid use disorder (OUD). The administration of buprenorphine treatment within a primary care environment. The study examines the incidence of lethal and non-lethal drug overdoses and fatalities over five years. Additionally, the research considers the quality-adjusted life years (QALYs) discounted throughout a lifetime and the associated costs. 

In a cohort of 100,000 individuals who have not received any treatment and are subjected to opioid agonist treatment (OBBT), it is estimated that around 9,350 cases of overdose would be prevented over five years. Out of these, approximately 900 cases would have resulted in fatalities. The utilization of OBBT, as opposed to the absence of treatment, results in an additional 1.07 QALYs per individual over their lifetime. This gain in QALYs is accompanied by an increased cost of $17,000 per QALY gained from a healthcare perspective. In the scenario where OBBT is only half as productive but twice as costly as the baseline assumption, the incremental cost from a healthcare viewpoint amounts to $25,500 per quality-adjusted life year (QALY) obtained. From a narrow societal viewpoint that considers patient and criminal justice expenses, it can be inferred that OBBT is a cost-effective alternative to no treatment, even when assuming low effectiveness and high costs.

The expansion of OBBT, or opioid-based treatment, would be highly cost-effective compared to the absence of treatment from a healthcare standpoint. Furthermore, it would result in cost savings when considering reducing expenses related to criminal justice. Considering the ongoing opioid epidemic in the United States, it is imperative to prioritize the expansion of this treatment alternative.

Source: sciencedirect.com/science/article/abs/pii/S0376871622004999