Back to Journals » ClinicoEconomics and Outcomes Research » Volume 12

Healthcare Resource Use and Cost: The Impact of Adopting an Abuse-Deterrent Formulation of Extended Release Morphine

Authors Rossiter LF, Kwong WJ, Marrett E

Received 9 August 2019

Accepted for publication 8 November 2019

Published 15 January 2020 Volume 2020:12 Pages 35—44


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Dean Smith

Louis F Rossiter, 1 Winghan Jacqueline Kwong, 2 Elizabeth Marrett 2

1The College of William and Mary, Williamsburg, VA 23187, USA; 2US Medical Affairs, Daiichi Sankyo, Inc., Basking Ridge, NJ 07920, USA

Correspondence: Elizabeth Marrett
US Medical Affairs Daiichi Sankyo, Inc., 211 Mt. Airy Road, Basking Ridge, NJ 07920, USA
Tel +908 992 7050

Background: Development of abuse-deterrent formulations (ADFs) of prescription opioids (RxO) is an important step toward reducing misuse and abuse. Morphine-ARER (MorphaBond™ ER) is an extended-release (ER) morphine sulfate tablet formulated to deter misuse/abuse via intravenous (IV) and intranasal (IN) routes of administration.
Objective: A model was developed to estimate the budget impact to a hypothetical commercial health plan of 10 million members 2 years after adding morphine-ARER to drug formulary.
Methods: We analyzed incremental health care resource use (HCRU) associated with RxO misuse/abuse based on a health plan’s RxO formulary coverage and patterns of misuse/abuse. Misuse/abuse rates, incremental HCRU and associated costs were based on the 2015 National Survey on Drug Use and Health, an analysis of claims from OptumHealth Care Solutions, Inc. (2013– 2015) and published literature. RxO formulary shares were based on 2016– 2017 Symphony Retail Prescription data. Morphine-ARER was assumed to capture 20 and 30 percent from branded and 0.3 and 0.6 percent from generic non-ADF ER morphine, in the first and second years, respectively. Proportions of misuse/abuse deterred by physical/chemical properties of morphine-ARER were assumed to be 90 percent via IV and 60 percent via IN administration, with further IN deterrence based on results from morphine-ARER’s human abuse liability study.
Results: Adding morphine-ARER to formulary resulted in a potential decrease in abuserelated healthcare costs by $557,321 (−$0.00232 per-member per-month [PMPM]), offsetting a pharmacy cost increase of $217,045 (+$0.00090 PMPM), resulting in net cost-savings of $0.00142 PMPM over 2 years, based on certain model assumptions.
Conclusion: Placing morphine-ARER on a health plan’s drug formulary may result in reduced misuse/abuse and overall cost savings.

Keywords: prescription opioids, abuse-deterrent formulations, drug formulary change, budget impact

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]