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The following is a summary of “Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder,” published in the November 2024 issue of Emergency Medicine by Lu et al. 

Researchers conducted a retrospective study to correlate the cost-effectiveness of implementation facilitation and a standard educational strategy in promoting emergency department (ED) -initiated buprenorphine with linkage to ongoing opioid use disorder care in the community from a healthcare sector perspective.  

They performed a cost-effectiveness analysis in “Project ED Health” (CTN-0069), a hybrid type 3 implementation-effectiveness study conducted in 4 academic EDs. The resources were collected and evaluated from a healthcare-sector, 3 effectiveness measures were analyzed: quality-adjusted life-years, opioid-free years, and participation in community-based opioid use disorder care 30 days after the initial ED visit. An incremental cost-effectiveness ratio was determined for each outcome, with probabilities assessed across various “value” thresholds using cost-effectiveness acceptability curves.  

The results showed that the mean per-person healthcare-sector cost for ED-administered buprenorphine following implementation facilitation was comparable to standard education ($3,239 vs $4,904), with no significant difference. However, the mean effectiveness across all 3 measures significantly favored the implementation facilitation strategy. An implementation facilitation demonstrated a 74% to 75% likelihood of being cost-effective at the recommended value range of $100,000 to $200,000 per quality-adjusted life-year from a healthcare-sector perspective. Incremental cost-effectiveness ratios based on secondary effectiveness measures showed a 75% probability of cost-effectiveness at $25,000 per opioid-free year and $38,000 per engagement.  

Investigators concluded that the implementation facilitation, compared to a standard educational strategy, had a moderate-to-high probability of being cost-effective from a healthcare-sector perspective, based on decision-makers willingness to pay for effective outcomes. 

Source: annemergmed.com/article/S0196-0644(24)01116-8/abstract