[PMH25] Medicaid population budget impact analysis of buprenorphine/naloxone film and tablet formulation

[PMH25] Medicaid population budget impact analysis of buprenorphine/naloxone film and tablet formulation

2014 Value in health

Clay, E. | Kharitonova, E. | Ruby, J. | Aballea, S. | Zah, V. | Volume: 17, Issue: 3, Pages: A212, analysis, budget impact,

o
bje
C
tives:
Buprenorphine/naloxone (BUP/NAL) for the treatment of opioid
de
pendence combination is available in film (since September 2010) and tablet
formulation. Earlier studies showed that treatment with BUP/NAL film formu

lation leads to an improved treatment persistence and lower health care costs
compared to BUP/NAL tablet formulation. A budget impact analysis was built to
assess the health care expenditures related to new patients entering treatment in
scenarios characterized by different market shares of the two BUP/NAL formula

tions.
Methods:
A Markov model was structured tracking a cohort of patients
initiating opioid dependence treatment with BUP/NAL film or BUP/NAL tablet
formulation through successive phases of treatment: initiation, maintenance, dis

continuation, off treatment and reinitiation. Transition probabilities and resource
utilization were estimated from a Marketscan Multi-State Medicaid database. The
total health care expenditure over five years was predicted for 65.6 million mem

bers for the following scenarios: 1) 100% market share BUP/NAL film formulation,
2) 100% market share BUP/NAL tablet formulation broken between all BUP/NAL
tablet formulations currently available in the market.
Resul
ts:
In the first year,
for Scenario 1 (100% on BUP/NAL Film) costs of medication acquisition were found
to be %6.1 (-US$18.1 million) lower. Costs of outpatient care were 31.65% (US$110.6
million) higher. Nevertheless, this difference was outweighed by lower costs of
inpatient care (-36.09%) (-US$129.9 million), and emergency room (-7.96%) (-US$3.3
million). Scenario 1 total health care costs were 4.2% and 9.4% lower in the first
year and cumulatively over five years, respectively.
Con
C
lusions:
Treatment
with buprenorphine/naloxone film results in less health care resource utilization
and lower total cost burden for Medicaid plans when compared to treatment with
buprenorphine/naloxone tablet