o
bje
C
tives:
Buprenorphine/naloxone (BUP/NAL) combination for the treatment of
opioid dependence is available in Film (since September 2010) and tablet formulations. Earlier studies showed that treatment with film leads to better persistence
and lower health care costs compared to BUP/NAL tablet. Higher costs were related
to higher relapse and reinitiation rates found in the tablet treated groups. Based on
these scientific analyses, 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 formulations.
Methods:
A
Markov model was structured tracking a cohort of patients initiating opioid
dependence treatment with BUP/NAL film or BUP/NAL tablet through successive
phases of treatment: initiation, maintenance, discontinuation, off treatment and
reinitiation. Transition probabilities and resource utilization were estimated from
a private insurance claims database. The total health care expenditure over five
years was predicted for 1,000,000 lives 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, costs of medication acquisition were found to
be 14.4% (-US$597,244) lower in the Scenario 1. Costs of laboratory tests were 71.9%
(US$371,547) higher. Nevertheless, this difference was outweighed by lower costs
of outpatient care (-4.7%) (-US$88,493), inpatient psychiatric care (-51.2%) (-US$1.8
million) and inpatient non-psychiatric care (-16.7%) (-US$703,780). Scenario 1 total
health care costs were were19.7% (US$2.8 million) and 16.5% (US$17.2 million) 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 private insurers when compared to treatment with buprenorphine/naloxone tablet