Enhancing Outcomes in Opioid Use Disorder Treatment: An Economic Evaluation of Improving Medication Adherence for Buprenorphine Through Blister-Packaging.

IF 5.1 Q1 SUBSTANCE ABUSE Substance Abuse and Rehabilitation Pub Date : 2024-10-22 eCollection Date: 2024-01-01 DOI:10.2147/SAR.S484831
Eric P Borrelli, Peter Saad, Nathan E Barnes, Heather Nelkin, Doina Dumitru, Julia D Lucaci
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Abstract

Background: The opioid epidemic has severely impacted the US over the last 15 years. Buprenorphine is a partial opioid agonist indicated for the treatment of opioid use disorder (OUD) and is recognized as an effective treatment when taken as prescribed. However, adherence rates have been low in real-world settings. Blister-packaging has been shown to promote medication adherence across a variety of disease states, although it has never been studied in OUD.

Methods: An economic analysis was conducted to assess the impact of increased adherence of blister-packaged buprenorphine on health care resource utilization (HCRU) and health care costs for 10,000 patients initiating therapy for OUD. The model analyzed a commercially insured population within the US over a one-year time horizon. Medication adherence was defined in the model as proportion of days covered (PDC) of at least 80%. Literature-based references were used to inform both the impact of blister-packaging on the number of patients who became adherent as well as the impact of medication adherence on HCRU and health care costs. Model input uncertainty was assessed in one-way sensitivity analyses.

Results: With the implementation of blister-packaging buprenorphine, adherence rates increased from 37.1% of patients in the pre-intervention period to 45.3%, resulting in an additional 818 patients becoming adherent post-intervention. The increase in adherence led to a reduction of medical costs of $12,138,757 (-$1,214 per-patient (PP)). Specifically, inpatient costs decreased by $7,127,073 (-$713 PP) while outpatient costs decreased by $5,013,319 (-$501 PP). Pharmacy costs increased by $3,432,705 ($343 PP). Despite the increase in pharmacy costs, total health care costs saw a reduction of $8,559,684 (-$856 PP).

Conclusion: Blister-packaging buprenorphine for treatment of OUD has potential to improve medication adherence and health outcomes while reducing HCRU and health care costs. Future studies are necessary to assess the real-world application and impact of blister-packaging buprenorphine for OUD across various patient populations and health care settings.

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提高阿片类药物使用障碍的治疗效果:通过泡罩包装改善丁丙诺啡用药依从性的经济评估》。
背景:在过去的 15 年里,阿片类药物的流行严重影响了美国。丁丙诺啡是一种部分阿片受体激动剂,用于治疗阿片类药物使用障碍(OUD),按处方服用是公认的有效治疗方法。然而,在现实环境中,其依从率一直很低。泡罩包装已被证明可促进多种疾病的用药依从性,但从未在 OUD 中进行过研究:方法:我们进行了一项经济分析,以评估泡罩包装丁丙诺啡的依从性提高对 10,000 名开始接受 OUD 治疗的患者的医疗资源利用率 (HCRU) 和医疗成本的影响。该模型对美国商业保险人群进行了为期一年的分析。该模型将用药依从性定义为至少 80% 的覆盖天数比例 (PDC)。泡罩包装对坚持用药的患者人数的影响以及坚持用药对 HCRU 和医疗成本的影响均以文献参考为依据。在单向敏感性分析中对模型输入的不确定性进行了评估:实施泡罩包装丁丙诺啡后,患者的依从性从干预前的 37.1% 提高到 45.3%,干预后依从性提高的患者增加了 818 人。依从性的提高使医疗费用减少了 12,138,757 美元(每位患者减少 1,214 美元)。具体来说,住院费用减少了 7,127,073 美元(-713 美元/人),门诊费用减少了 5,013,319 美元(-501 美元/人)。药房费用增加了 3,432,705 美元(343 人民币)。尽管药房费用有所增加,但医疗费用总额却减少了 8,559,684 美元(-856 PP 美元):结论:采用泡罩包装丁丙诺啡治疗 OUD 有可能改善用药依从性和医疗效果,同时降低 HCRU 和医疗成本。未来有必要开展研究,以评估泡罩包装丁丙诺啡治疗 OUD 在不同患者群体和医疗环境中的实际应用和影响。
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发文量
9
审稿时长
16 weeks
期刊最新文献
Patient Perceived Impact of Outpatient Group Substance Use Disorder Treatment in a Hybrid Model or Virtual-Only Model Relative to In-Person Delivery. Enhancing Outcomes in Opioid Use Disorder Treatment: An Economic Evaluation of Improving Medication Adherence for Buprenorphine Through Blister-Packaging. A Framework for a New Paradigm of Opioid Drug Tapering Using Adjunct Drugs. Incidence, Timing and Social Correlates of the Development of Opioid Use Disorder Among Clients Seeking Treatment for an Alcohol Use Problem: Changes Over the Three Waves of the Opioid Epidemic. Community-Based Medications First for Opioid Use Disorder - Care Utilization and Mortality Outcomes.
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