Informing evidence-based medicine for opioid use disorder using pharmacoeconomic studies

ABSTRACT

Introduction

The health and economic consequences of inadequately treated opioid use disorder (OUD) are substantial. Healthcare systems in the United States (US) and other countries are facing a growing healthcare crisis due to opioids. Although effective medications for OUD exist, relying solely on clinical information is insufficient for addressing the opioid crisis.

Areas Covered

In this review, the role of pharmacoeconomic studies in informing evidence-based medication treatment for OUD is discussed, with a particular emphasis on the US healthcare system, where the economic burden is significantly higher than the global average. The scope/objective of pharmacoeconomics as a distinct scientific research program is briefly defined, followed by a discussion of existing evidence informed by data from systematic reviews, in addition to a convenience sample of recently published pharmacoeconomic studies and protocols. The review also explores the need for methodological advancements in the field.

Expert Opinion

Despite the potential of pharmacoeconomic research in shaping evidence-based medicine for OUD, significant challenges limiting its real-world application remain. How to address these challenges are explored, including how to combine cost-effectiveness and budget impact analyses to address the needs of the healthcare system as a whole and specific stakeholders interested in adopting new OUD treatment strategies.

KEYWORDS:

• Opioid use disorder
• pharmacoeconomics
• cost-effectiveness analysis
• budget impact analysis
• methadone
• buprenorphine

Article highlights

• Pharmacoeconomics is a specialized branch of health economics concerned with evaluating the comparative clinical, person-centered, and economic outcomes of medical interventions, including adjuvant treatments, products, and services.

• Data generated from pharmacoeconomic studies, such as cost-effectiveness and budget-impact analyses, provide necessary, though not solely sufficient, information for medical decision-making.

• Systematic reviews have determined that opioid agonist medications, such as methadone and buprenorphine, are cost-effective for treating opioid use disorder (OUD) compared to non-pharmacological interventions. However, additional research is needed to identify the optimal medications, formulations, delivery methods, healthcare settings, and treatment linkage strategies for high-risk, vulnerable populations with OUD.

• Continued investment by federal agencies in supporting pharmacoeconomic research conducted alongside or in conjunction with clinical trials is critical for advancing the field. These studies are the primary sources of robust, participant-level health economic data needed to inform evidence-based medicine for OUD.

• There is an anticipated need for researchers to study and validate the most appropriate econometric research designs for future pharmacoeconomic studies. Therefore, federal funding should be expanded to be more favorable to methodological research proposals.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The author would like to thank Shashi Kapadia, MD for providing helpful comments on an early version of the manuscript.

Additional information

Funding

The author acknowledges partial financial support for this manuscript from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) under award numbers R03DA05746 and P30DA040500. The content of the article is solely the responsibility of the author and does not necessarily represent the official views of the NIH.