Healthcare utilization and costs associated with treatment for opioid dependence

Abstract

Objective: Opioid use disorder (OUD) can be managed with medication assisted therapy (MAT) (methadone [MET], buprenorphine [BUP], or extended-release naltrexone [XR-NTX]) or counseling alone (non-pharmacological therapy [NPT]). The objective of this study was to evaluate healthcare resource utilization and costs associated with XR-NTX compared with alternative treatments for opioid dependence.

Methods: Adults with a diagnosis of opioid dependence who initiated treatment with XR-NTX, BUP, MET, or NPT between January 1, 2011 and December 31, 2014 were identified in the Truven Health MarketScan Commercial administrative claims database. Healthcare resource utilization, costs (inpatient [IP], emergency department [ED], outpatient [OP], and pharmacy) and adherence were evaluated for each cohort during 12-month baseline and follow-up periods.

Results: A total of 29,235 patients were included in the analysis; 1,041, 20,566, 745, and 6,883 received XR-NTX, BUP, MET, and NPT, respectively. Patients in the XR-NTX cohort were significantly younger and had more comorbidities compared with the other cohorts. Patients in the XR-NTX group had the largest percentage decrease in IP and ED utilization and costs from baseline to follow-up. OP and pharmacy costs increased significantly from baseline to follow-up for all cohorts. Overall, there was no significant change in total healthcare costs for the XR-NTX group, whereas the costs increased significantly for other groups (BUP = +43%, MET = +47.7%, NPT = +38.8%).

Conclusions: Healthcare resource utilization and costs increased from baseline to follow-up in BUP, MET, and NPT patients, whereas patients receiving XR-NTX experienced no such increase. This analysis suggests there may be economic value in the use of XR-NTX for OUD.

Keywords:

• Naltrexone
• opioid dependence
• buprenorphine
• methadone
• healthcare costs
• healthcare resource utilization

Transparency

Declaration of funding

This research was funded by Alkermes, Inc.

Declaration of financial/other relationships

AS and NA are full-time employees and minor shareholders of Alkermes, Inc. MD and MG were employed at Alkermes, Inc. when the study was conducted. KST is an employee for Symlink, LLC, which has received research funds from Alkermes, Inc. in connection with conducting this study and development of this manuscript. Peer reviewers on this manuscript have received an honorarium from JME for their review work, but have no other relevant financial relationships to disclose.

Acknowledgments

The authors would like to thank Xiaowu Sun for assistance in performing statistical analyses for this study. Xiaowu Sun is an employee and minor shareholder of Alkermes, Inc.