Real-world reduction in healthcare resource utilization following treatment of opioid use disorder with reSET-O, a novel prescription digital therapeutic

ABSTRACT

Introduction

Buprenorphine medication assisted treatment (B-MAT) adherence for opioid use disorder (OUD) is suboptimal. reSET-O, an FDA-cleared prescription digital therapeutic, delivers neurobehavioral therapy (community-reinforcement approach+fluency training+contingency management) to B-MAT-treated OUD patients.

Methods

This retrospective claims study (10/01/2018-10/31/2019) evaluated healthcare resource utilization up to 6 months before/after reSET-O initiation. Repeated-measures negative binomial models compared incidences of encounters/procedures. Net change in costs was assessed.

Results

Among 351 patients (mean age 37; 59.5% female; 82.6% Medicaid), 334 had pharmacy claims and 240 (71.9%) received buprenorphine pre-/post-index (medication possession ratio 0.73 and 0.82, respectively; P = 0.004). Facility encounters decreased, with 45 fewer inpatient (P = 0.024) and 27 fewer emergency department (ED) visits (P = 0.247). Clinical encounters with largest changes were drug testing (638 fewer; P < 0.001), psychiatry (349 fewer; P = 0.036), case management (176 additional; P = 0.588), other pathology/laboratory (166 fewer; P = 0.039), office/other outpatient (154 fewer; P = 0.302), behavioral rehabilitation (111 additional; P = 0.124), alcohol/substance rehabilitation (96 fewer; P = 0.348), other rehabilitation (66 fewer; P = 0.387), mental health rehabilitation (61 additional; P = 0.097), and surgery (60 fewer; P = 0.070). Changes in facility/clinical encounters saved $2,150/patient.

Conclusion

reSET-O initiation was associated with fewer inpatient, ED, and other clinical encounters, increased case management/rehabilitative services, and lower net costs over six months.

Expert Opinion

Real-world evidence is helpful in evaluating the effectiveness of interventions in usual-care conditions, outside of controlled research environments. Large observational studies based on health care claims are important to understand the actual pharmacoeconomic and outcomes impact of interventions at the health care system and population level.

KEYWORDS:

• Opioid use disorder (OUD)
• prescription digital therapeutic (PDT)
• reSET-O
• therapeutic education system (TES)
• community reinforcement approach (CRA)
• contingency management (CM)

Acknowledgments

The authors would like to thank Dr. Sean Murphy for his helpful insights during critical review of the results, Dr. Heather Shapiro for her assistance with data integrity and manuscript review, Natalie Edwards for assistance with writing support and critical review of the manuscript, and most of all to the patients for their courage in the face of all the challenges on the road to recovery.

Author contribution statement

All authors were involved with conception, study design, interpretation of the data, writing the manuscript, and the final approval of the version to be published.

Data availability statement

The data that support the findings of this study are available from the authors upon reasonable request and with permission from HealthVerity.

Declaration of interest

FFV is an employee of Pear Therapeutics, Inc. SC, LK, CR, and KA provided consulting services to Pear Therapeutics, Inc. for the conduct of the study. No author received an honorarium related to the development of this manuscript. The authors have 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.

Reviewers disclosure

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

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by Pear Therapeutics, Inc.