Real-world reduction in healthcare resource utilization following treatment of opioid use disorder with reSET-O, a novel prescription digital therapeutic

Abstract

Introduction: Buprenorphine medication assisted treatment (B-MAT) adherence for opioid use disorder (OUD) is suboptimal. reSET-O, an FDA-cleared prescription digital therapeutic, delivers neurobehavioral therapy (community-reinforcement approach+fluency training+contingency management) to B-MATtreated OUD patients. Methods: This retrospective claims study (10/01/2018-10/31/2019) evaluated healthcare resource utilization up to 6 months before/after reSET-O initiation. Repeated-measures negative binomial models compared incidences of encounters/procedures. Net change in costs was assessed. Results: Among 351 patients (mean age 37; 59.5% female; 82.6% Medicaid), 334 had pharmacy claims and 240 (71.9%) received buprenorphine pre-/post-index (medication possession ratio 0.73 and 0.82, respectively; P = 0.004). Facility encounters decreased, with 45 fewer inpatient (P = 0.024) and 27 fewer emergency department (ED) visits (P = 0.247). Clinical encounters with largest changes were drug testing (638 fewer; P < 0.001), psychiatry (349 fewer; P = 0.036), case management (176 additional; P = 0.588), other pathology/laboratory (166 fewer; P = 0.039), office/other outpatient (154 fewer; P = 0.302), behavioral rehabilitation (111 additional; P = 0.124), alcohol/substance rehabilitation (96 fewer; P = 0.348), other rehabilitation (66 fewer; P = 0.387), mental health rehabilitation (61 additional; P = 0.097), and surgery (60 fewer; P = 0.070). Changes in facility/clinical encounters saved $2,150/ patient. Conclusion: reSET-O initiation was associated with fewer inpatient, ED, and other clinical encounters, increased case management/rehabilitative services, and lower net costs over six months. Expert Opinion: Real-world evidence is helpful in evaluating the effectiveness of interventions in usualcare conditions, outside of controlled research environments. Large observational studies based on health care claims are important to understand the actual pharmacoeconomic and outcomes impact of interventions at the health care system and population level.

Leveraging applied behavior analysis research and practice in the service of public health

“…One evaluation of re-SET-O (i.e., during typical day-to-day clinical care) found that of the 3,144 patients followed across 30 states, 66% were abstinent as defined by self-report or drug negative urinalysis (missing data were considered positive; Maricich et al, 2020). Another study found decreases in healthcare utilization (e.g., emergency room and hospital visits) following use of re-SET-O with an estimated total savings of $750,000 for the 351 treatment patients (i.e., savings of $2,150 per patient) (Velez et al, 2021).…”

Evidence of long-term real-world reduction in healthcare resource utilization following treatment of opioid use disorder with reSET-O, a novel prescription digital therapeutic

“…In November 2020, we published in this journal a retrospective claims study evaluating changes in healthcare resource utilization following the initiation of reSET-O among 351 predominantly Medicaid-covered (82.6%) patients with OUD [7]. That analysis showed a net reduction in medical costs of 2,150 USD per patient 6 months post initiation of reSET-O, driven in large part by a reduction in inpatient (IP) stays and emergency department (ED) visits, but also by a reduced utilization of presumptive and definitive drug testing for a variety of substances, and through the substitution of face-to-face counseling sessions (CPT codes for individual and group psychotherapy: 90,785-90,876).…”

Comparison of GIS-based AHP and fuzzy AHP methods for hospital site selection: a case study for Prayagraj City, India

“…Over the period of time, the demand for healthcare facilities has increased exponentially all over the world (Pantzartzis et al, 2017;Velez et al, 2021). Healthcare services play an essential role in the socioeconomic development of any nation.…”