دورية أكاديمية
أعرض في EDS

Economic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder.

التفاصيل البيبلوغرافية
العنوان: Economic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder.
المؤلفون: Flam-Ross JM; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.; Now with London School of Hygiene and Tropical Medicine, London, United Kingdom., Marsh E; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts., Weitz M; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts., Savinkina A; Yale School of Public Health, New Haven, Connecticut., Schackman BR; Department of Population Health Sciences, Weill Cornell Medical College, New York, New York., Wang J; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts., Madushani RWMA; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts., Morgan JR; Boston University School of Public Health, Boston, Massachusetts., Barocas JA; Section of General Internal Medicine and Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora., Walley AY; Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts., Chrysanthopoulou SA; Department of Biostatistics, Brown University School of Public Health, Brown University, Providence, Rhode Island., Linas BP; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.; Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.; Boston University School of Public Health, Boston, Massachusetts., Assoumou SA; Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts.; Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
المصدر: JAMA network open [JAMA Netw Open] 2023 Sep 05; Vol. 6 (9), pp. e2329583. Date of Electronic Publication: 2023 Sep 05.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Buprenorphine*/therapeutic use , Opioid-Related Disorders*/drug therapy, Adult ; Female ; Humans ; Male ; Middle Aged ; Cost-Benefit Analysis ; Patient Acceptance of Health Care ; United States
مستخلص: Importance: In 2017, the US Food and Drug Administration (FDA) approved a monthly injectable form of buprenorphine, extended-release buprenorphine; published data show that extended-release buprenorphine is effective compared with no treatment, but its current cost is higher and current retention is lower than that of transmucosal buprenorphine. Preliminary research suggests that extended-release buprenorphine may be an important addition to treatment options, but the cost-effectiveness of extended-release buprenorphine compared with transmucosal buprenorphine remains unclear.
Objective: To evaluate the cost-effectiveness of extended-release buprenorphine compared with transmucosal buprenorphine.
Design, Setting, and Participants: This economic evaluation used a state transition model starting in 2019 to simulate the lifetime of a closed cohort of individuals with OUD presenting for evaluation for opioid agonist treatment with buprenorphine. The data sources used to estimate model parameters included cohort studies, clinical trials, and administrative data. The model relied on pharmaceutical costs from the Federal Supply Schedule and health care utilization costs from published studies. Data were analyzed from September 2021 to January 2023.
Interventions: No treatment, treatment with transmucosal buprenorphine, or treatment with extended-release buprenorphine.
Main Outcomes and Measures: Mean lifetime costs per person, discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs).
Results: The simulated cohort included 100 000 patients with OUD receiving (61% male; mean [SD] age, 38 [11] years) or not receiving medication treatment (58% male, mean [SD] age, 48 [18] years). Compared with no medication treatment, treatment with transmucosal buprenorphine yielded an ICER of $19 740 per QALY. Compared with treatment with transmucosal buprenorphine, treatment with extended-release buprenorphine yielded lower effectiveness by 0.03 QALYs per person at higher cost, suggesting that treatment with extended-release buprenorphine was dominated and not preferred. In probabilistic sensitivity analyses, treatment with transmucosal buprenorphine was the preferred strategy 60% of the time. Treatment with extended-release buprenorphine was cost-effective compared with treatment with transmucosal buprenorphine at a $100 000 per QALY willingness-to-pay threshold only after substantial changes in key parameters.
Conclusions and Relevance: In this economic evaluation of extended-release buprenorphine compared with transmucosal buprenorphine for the treatment of OUD, extended-release buprenorphine was not associated with efficient allocation of limited resources when transmucosal buprenorphine was available. Future initiatives should aim to improve retention rates or decrease costs associated with extended-release buprenorphine.
التعليقات: Comment in: JAMA Netw Open. 2023 Sep 5;6(9):e2329677. doi: 10.1001/jamanetworkopen.2023.29677. (PMID: 37703021)
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معلومات مُعتمدة: R01 DA046527 United States DA NIDA NIH HHS; K01 DA051684 United States DA NIDA NIH HHS; P30 DA040500 United States DA NIDA NIH HHS; DP2 DA051864 United States DA NIDA NIH HHS; K23 DA044085 United States DA NIDA NIH HHS
المشرفين على المادة: 40D3SCR4GZ (Buprenorphine)
تواريخ الأحداث: Date Created: 20230913 Date Completed: 20231010 Latest Revision: 20240626
رمز التحديث: 20240626
مُعرف محوري في PubMed: PMC10500382
DOI: 10.1001/jamanetworkopen.2023.29583
PMID: 37703018
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2023.29583