Persistence and Healthcare Utilization Associated with the Use of Buprenorphine/Naloxone Film and Tablet Formulation Therapy in Adults with Opioid Dependence

Persistence and Healthcare Utilization Associated with the Use of Buprenorphine/Naloxone Film and Tablet Formulation Therapy in Adults with Opioid Dependence

2014 J Med Econ

Clay, E. | Khemiri, A. | Zah, V. | Aballea, S. | Ruby, J. | Asche, C.V. | Volume: 6, Issue: , Pages: 1-11, Adult, analysis, database, database analysis, economics, France, Health Care Costs, methods, opioid dependence, Risk, therapy, utilization,

Abstract Background: Buprenorphine/naloxone film was developed to improve retention in treatment with a faster dissolution and reduce public health risks over the tablet formulation for opioid dependence. Objectives: To compare patient persistence and resource utilization between formulations for the treatment of opioid dependence. Methods: A longitudinal, retrospective cohort analysis was conducted to compare persistence and healthcare costs in a private U.S. insurance claims database. Previously untreated patients, who initiated treatment with buprenorphine/naloxone following the introduction of the film, were classified in two groups according to the initial prescription. Persistence was defined as the proportion of patients continuing treatment for at least 6 months. Resource utilization and related costs were calculated over the 6- and 12-month periods after treatment initiation. Results: Film and tablet groups included 2,796 and 1,510 patients enrolled over 9.76 and 13.76 months on average respectively, from initiation of treatment. Patient characteristics were similar between groups. Mean prescribed doses were 14.62 and 14.26 mg/day in film and tablet groups. Among patients enrolled for at least 6 months from the initial treatment, persistence rates were 63.78% with film vs. 58.13% with tablet. Time to treatment discontinuation was longer in the film group, with a hazard ratio of 0.818 (p=0.0005, 95% CI: [0.730;0.916]) adjusted for baseline characteristics. Patients treated with film had significantly more outpatient visits (+4%, p=0.0185) and lower probability to be hospitalized (-17%, p=0.0158), resulting in lower total healthcare costsover the 12-month period after initiation (-27%, p<0.0001). Conclusions: Patients treated with the film formulation of buprenorphine/naloxone appeared to stay longer on treatment, have a lower probability of hospital admission and lower health care costs compared to patients treated with the tablet. This study, based on insurance claims data, has the advantage of reflecting real-world practice, but one cannot rule out the existence of bias due to differences in patient or prescriber profiles, despite adjustments made for observed characteristics at treatment initiation

https://www.doi.org/10.3111/13696998.2014.925463