Opioid Drug Utilization and Cost Outcomes Associated With the Use of Buprenorphine-Naloxone in Patients With a History of Prescription Opioid Use

Assessment of Student Performance and Perceptions of Learning in a Medication Use Evaluation Project

“…Multiple recent examples of pharmacistcoordinated MUE projects in various therapeutic areas, in both institutional [3][4][5][6][7] (eg, assessing effectiveness of a vancomycin dosing nomogram) and managed care [8][9][10] (eg, assessing whether tamoxifen is being used for evidence-based, off-label indications) settings, are available in the literature. MUE is not explicitly described in the Accreditation Council for Pharmacy Education (ACPE) Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree; however, several topics related to MUE are described in Appendix B of the standards (ie, suggested didactic topics) including "managing and improving the medication use process" and "continuous quality improvement programs."…”

Is Buprenorphine-Naloxone Ready for Prime Time in the Treatment of Opioid Addiction in Managed Care?

“…1 Persistence with this intervention therapy to treat patients with a history of prescription opioid use was only 48% at month 1, 27% at month 6, and 20% at month 12. Even for the small proportion of patients persistent on buprenorphinenaloxone, we do not know any clinical outcome measures including the effect on illicit drug use or prescription opiate use not captured in the pharmacy claims system.…”

Opioid Dependence Treatment and Guidelines

“…Currently no studies have evaluated gaps in therapy greater than one month, which may indicate relapse and restarts of treatment, so it is challenging to identify true rates of relapse. 28 Results showed that almost one-half (47.5%) of patients requiring opioid detoxification did not receive prescription opioids through an outpatient pharmacy during the 6-month period preceding opioid detoxification, suggesting that patients in need of buprenorphine-naloxone therapy obtain opioids illicitly, or use other illicit drugs, such as heroin. It is difficult to evaluate true cost savings of therapy as administrative claims databases do not capture the cost of illicit opioid use.…”

“…A retrospective drug use evaluation was conducted on patients receiving buprenorphine-naloxone in a managed care population. 28 Persistence was determined by examining prescription claims data and defined as a gap of 30 days or less between expected refill date and the actual refill date. A total of 84 patients met study inclusion criteria; among these patients, the study found persistence rates of 47.6% at 1 month, 27.4% at 6 months, and 20.2% at 12 months.…”

“…It is difficult to evaluate true cost savings of therapy as administrative claims databases do not capture the cost of illicit opioid use. 28 In a retrospective chart review, Caldiero et al reported that patients had an average of 3.4 prior substance use treatments prior to receiving induction of buprenorphine. 29 One recent study found the cost of providing 1 month of treatment per patient was $147 in methadone clinic treatments, $220 in methadone office treatments, and $336 buprenorphine office treatments (P < 0.001).…”