Evaluation of the cost-utility of a prescription digital therapeutic for the treatment of opioid use disorder

ABSTRACT

Background: The opioid epidemic continues to generate a significant mental and physical health burden on patients, and claims the life of almost 150 Americans daily. Making matters worse, an increase in relapses and/or opioid-related deaths has been reported in more than 40 U.S. states since the start of the COVID-19 pandemic. Opioid use disorder (OUD) is one of the single most expensive disorders in the United States, generating average medical costs of $60B from just 2 million Americans diagnosed with the disorder. In commercial use since 2019, reSET-O is a non-drug, prescription digital therapeutic (PDT) that delivers evidence-based neurobehavioral treatment for OUD and helps overcome the barriers associated with access to care, stigma, and social distancing. Although shown to be cost effective and efficacious in clinical trials and real-world evidence studies, respectively, information on its value for money from a health utilities and cost per quality-adjusted life-year is needed to inform policy discussions.

Objectives: To evaluate the impact of reSET-O on health utilities and assess its overall cost per quality-adjusted life year (QALY) gained vs. treatment-as-usual (TAU).

Methods: Decision analytic model comparing reSET-O plus TAU to TAU alone (i.e. buprenorphine, face-to-face counseling, and contingency management) over 12 weeks. Clinical effectiveness data (abstinence and health utility) were obtained from a clinical trial, and resource utilization and cost data were adapted from a recent claims data analysis to reflect less frequent face-to-face counseling with the therapeutic.

Results: The addition of reSET-O to TAU decreases total health care costs by -$131 and resulted in post-treatment utility values within population norms, with a corresponding gain of 0.003 QALYs. reSET-O when used adjunctively to TAU was economically dominant (less costly, more effective) vs. TAU alone.

Conclusion: reSET-O is an economically-dominant adjunctive treatment for OUD and is associated with an overall reduction in total incremental cost vs TAU.

KEYWORDS:

• Prescription digital therapeutic
• PDT
• opioid use disorder
• opioid epidemic
• health utilities
• cost utility analysis
• neurobehavioral therapy
• quality-adjusted life-years
• QALY

Transparency

Declaration of financial/other relationships

FV, HFL and RG are all employees of Pear Therapeutics Inc.

BP, DMD, DCM are consultants to Pear Therapeutics Inc.

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

Acknowledgments

Writing and editorial support for the preparation of this abstract was provided by Natalie C. Edwards, MSc of Health Services Consulting Corporation and funded by Pear Therapeutics, Inc.

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was funded by Pear Therapeutics, Inc.