Economic evaluation: A comparison of methadone versus buprenorphine for opiate substitution treatment

Maas, Jim; Barton, Garry; Maskrey, Vivienne; Pinto, Hayley; Holland, Richard

doi:10.1016/j.drugalcdep.2013.07.018

Cited by 22 publications

(18 citation statements)

References 14 publications

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“…Maas et al[66] evaluated the cost-effectiveness of BMT relative to MMT among individuals with an opioid use disorder in the UK, using a non-equivalent group research design. The analyses were conducted from the provider perspective.…”

Section: Resultsmentioning

confidence: 99%

“…A number of studies compared MMT to other pharmacological therapies, including injectable heroin,[64, 65] BMT,[21, 31, 32, 66, 67] and naltrexone. [67] As can be seen in Table 6, all but one of these studies was rated as good.…”

Section: Discussionmentioning

confidence: 99%

“…Jones et al[31] found abstinence rates to be statistically similar for BMT and MMT, but MMT to be less expensive. Maas et al[66] found MMT to dominate BMT with regard to 6-month retention rates, but BMT to be more effective in terms of detox rates, generating an ICER of £903 [2010-2011 GBP] per individual who stopped using illicit opiates. Geitona et al[32] found BMT to be significantly less expensive than MMT from the Greek National Health System's perspective, and more effective with regard to participants completing therapy and deaths avoided.…”

Section: Discussionmentioning

confidence: 99%

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Economic Evaluations of Opioid Use Disorder Interventions

Murphy

Polsky

2016

PharmacoEconomics

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Background The economic costs associated with opioid misuse are immense. Effective interventions for opioid use disorders are available; however, given the scarce resources faced by substance-use treatment providers and payers of all kinds, evidence of effectiveness is not always sufficient to encourage the adoption of a given therapy, nor should it be. Economic evaluations can provide evidence that will help stakeholders efficiently allocate their resources. Objective The purpose of this study was to review the literature on economic evaluations of opioid use disorder interventions. Methods We performed a systematic review of the major electronic databases from inception until present (August 2015). A sensitive approach was used to ensure a comprehensive list of relevant articles. Given the quality of existing reviews, we narrowed our search to studies published since 2007. The Drummond checklist was used to evaluate and categorize economic-evaluation studies according to their quality. Results A total of 98 articles were identified as potentially relevant to the current study. Of these 98 articles, half (n=49) were included in this study. Six of the included articles were review in nature. The remaining 43 articles performed an economic evaluation of an intervention for opioid use disorders. In general, the evidence on methadone-maintenance therapy (MMT) supports previous findings that MMT is an economically advantageous opioid-use-disorder therapy. The economic literature comparing MMT to other opioid-use-disorder pharmacotherapies is limited, as is the literature on other forms of therapy. Conclusions With the possible exception of MMT, additional high-quality economic evaluations are needed in order to assess the relative value of existing opioid-use-disorder interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Economic Evaluations of Opioid Use Disorder Interventions

Murphy

Polsky

2016

PharmacoEconomics

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“…Retention in treatment has multiple definitions and measurements across studies, where some chose to define retention as a continuous value such as the number of days a patient continued in treatment until the last day of receiving an intervention receipt [46]; other studies chose to measure retention as a binary outcome such as the percentage of patients who completed their treatment course [47]; and lastly, some studies chose to report the number of patients who received the treatment for a predefined number of treatment days [39]. Due to the numerous ways retention is defined, measured, and reported, we will collect any information the articles offer on patient retention.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of opioid substitution treatments for patients with opioid dependence: a systematic review and multiple treatment comparison protocol

et al. 2014

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BackgroundOpioids are psychoactive analgesic drugs prescribed for pain relief and palliative care. Due to their addictive potential, effort and vigilance in controlling prescriptions is needed to avoid misuse and dependence. Despite the effort, the prevalence of opioid use disorder continues to rise. Opioid substitution therapies are commonly used to treat opioid dependence; however, there is minimal consensus as to which therapy is most effective. Available treatments include methadone, heroin, buprenorphine, as well as naltrexone. This systematic review aims to assess and compare the effect of all available opioid substitution therapies on the treatment of opioid dependence.Methods/DesignThe authors will search Medline, EMBASE, PubMed, PsycINFO, Web of Science, Cochrane Library, Cochrane Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform Search Portal, and the National Institutes for Health Clinical Trials Registry. The title, abstract, and full-text screening will be completed in duplicate. When appropriate, multiple treatment comparison Bayesian meta-analytic methods will be performed to deduce summary statistics estimating the effectiveness of all opioid substitution therapies in terms of retention and response to treatment (as measured through continued opioid abuse).DiscussionUsing evidence gained from this systematic review, we anticipate disseminating an objective review of the current available literature on the effectiveness of all opioid substitution therapies for the treatment of opioid use disorder. The results of this systematic review are imperative to the further enhancement of clinical practice in addiction medicine.Systematic review registrationPROSPERO CRD42013006507.

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“…Other studies have focused on meaningful comparisons regarding treatment modalities, efficacy methadone vs. bup/nal, and determination of risk factors for compliance and treatment success. Many of these studies have used short follow-up periods, and researchers have focused largely on retention rates, chart reviews, instances of buprenorphine administration, interviews, self-report of heroin use and criminal activity, and telephone or internet communication, to measure adherence and abstinence (Fareed et al, 2014;Maas, Barton, Maskrey, Pinto, & Holland, 2013;Mattick et al, 2014;Moore et al, 2016;Parran et al, 2010;Tkacz, Severt, Cacciola, & Ruetsch, 2012).…”

Section: Introductionmentioning

confidence: 99%

A Systematic, Intensive Statistical Investigation of Data from the Comprehensive Analysis of Reported Drugs (CARD) for Compliance and Illicit Opioid Abstinence in Substance Addiction Treatment with Buprenorphine/naloxone

Blum

Han

Modestino

et al. 2017

Substance Use & Misuse

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Background: Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delta mu antagonist, is presently recommended and used to treat opioid-use disorder. However, a literature review revealed a paucity of research involving data from urine drug tests that looked at compliance and abstinence in one sample. Method: Statistical analysis of data from the Comprehensive Analysis of Reported Drugs (CARD) was used to assess compliance and abstinence during treatment in a large cohort of bup/nal patients attending chemical-dependency programs from eastern USA in 2010 and 2011. Results: Part 1: Bup/nal was present in 93.4% of first (n = 1,282; p < .0001) and 92.4% of last (n = 1,268; p < .0001) urine samples. Concomitantly, unreported illicit drugs were present in 47.7% (n = 655, p = .0261) of samples. Patients who were compliant to the bup/nal prescription were more likely than noncompliant patients to be abstinent during treatment (p = .0012; odds ratio = 1.69 with 95% confidence interval (1.210, 2.354). Part 2: An analysis of all samples collected in 2011 revealed a significant improvement in both compliance (p < 2.2 × 10 −16 ) and abstinence (p < 2.2 × 10 −16 ) during treatment. Conclusion/Importance: While significant use of illicit opioids during treatment with bup/nal is present, improvements in abstinence and high compliance during maintenance-assisted therapy programs may ameliorate fears of diversion in comprehensive programs. Expanded clinical datasets, the treatment modality, location, and year of sampling are important covariates, for further studies. The potential for long-term antireward effects from bup/nal use requires consideration in future investigations.

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Economic evaluation: A comparison of methadone versus buprenorphine for opiate substitution treatment

Cited by 22 publications

References 14 publications

Economic Evaluations of Opioid Use Disorder Interventions

Economic Evaluations of Opioid Use Disorder Interventions

The effectiveness of opioid substitution treatments for patients with opioid dependence: a systematic review and multiple treatment comparison protocol

A Systematic, Intensive Statistical Investigation of Data from the Comprehensive Analysis of Reported Drugs (CARD) for Compliance and Illicit Opioid Abstinence in Substance Addiction Treatment with Buprenorphine/naloxone

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