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Budget Impact Analysis of the Introduction of Injectable Prolonged-Release Buprenorphine on Opioid Use Disorder Care Resource Requirements

Authors Phillips-Jackson H, Hallam C, Cullen N, Pearson T, Gilman M, Li L, Musgrave P

Received 19 December 2019

Accepted for publication 29 March 2020

Published 6 May 2020 Volume 2020:12 Pages 233—240


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Samer Hamidi

Helen Phillips-Jackson,1 Clive Hallam,2 Niamh Cullen,3 Terry Pearson,4 Mark Gilman,5 Li Li,6 Paul Musgrave7

1Working Group on Innovation Assessment, Expert Faculty on Commissioning, London, UK; 2Richmond and Wandsworth Council, London, UK; 3Public Health, Calderdale, UK; 4Northamptonshire County Council, Northamptonshire, UK; 5Discovering Health, Manchester, UK; 6Applied Strategic, London, UK; 7Public Health, Cumbria, UK

Correspondence: Paul Musgrave
Public Health, Cumbria, UK

Objective: To assess budget impact of the introduction of prolonged-release buprenorphine (PRB) for care of opioid use disorder (OUD) over 1 year in a defined population.
Materials and Methods: A healthcare perspective, decision-tree model analysis of the cost of OUD care for a standard population was prepared to compare two scenarios: treatment of a population under the existing standard of care, or with the addition of PRB. The model assessed OUD-related direct costs (medication, delivery, psychosocial treatment), other services costs (harm reduction, general healthcare, social and justice services) and the impact of behaviors such as engaging with treatment and electing to use additional opioids “on top” of treatment regimens, and “dropping out” from treatment.
Results: Standard population definition (persons offered OUD care services) is based on a typical administrative region in England with general population of  400,000 citizens, 1,777 high-risk opioid users requiring treatment and 909 patients initiating treatment in a year. The cost to provide OUD care for 1 year under the current scenario (70% treated with methadone, 30% sublingual buprenorphine) is £ 19.7M. In scenarios with increased PRB adoption/reduced sublingual buprenorphine or oral methadone use, the cost reduction ranges from £ 0.2M to  0.7M.
Conclusion: The assessment showed a reduction of overall costs after introduction of PRB.

Keywords: opioid use disorder, budget impact, pharmacotherapy, buprenorphine, methadone, injectable prolonged-release buprenorphine

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