Evaluation of the cost-utility of a prescription digital therapeutic for the treatment of opioid use disorder
| Autor: | Benjamin Parcher, Dylan Mezzio, Hilary F. Luderer, Fulton Velez, Robert Gerwien, Daniel C. Malone |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cost-Benefit Analysis Physical Distancing Social Stigma Population Contingency management 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Behavior Therapy Health care medicine Humans Opioid Epidemic Medical prescription education Intensive care medicine Pandemics education.field_of_study SARS-CoV-2 business.industry COVID-19 Opioid use disorder General Medicine Opioid-Related Disorders medicine.disease Clinical trial Adjunctive treatment Quality-Adjusted Life Years business Models Econometric Buprenorphine medicine.drug |
| Zdroj: | Postgraduate Medicine. 133:421-427 |
| ISSN: | 1941-9260 0032-5481 |
| Popis: | Background: The opioid epidemic continues to generate a significant mental and physical health burden on patients, and claims the life of almost 150 Americans daily. Making matters worse, an increase in relapses and/or opioid-related deaths has been reported in more than 40 U.S. states since the start of the COVID-19 pandemic. Opioid use disorder (OUD) is one of the single most expensive disorders in the United States, generating average medical costs of $60B from just 2 million Americans diagnosed with the disorder. In commercial use since 2019, reSET-O is a non-drug, prescription digital therapeutic (PDT) that delivers evidence-based neurobehavioral treatment for OUD and helps overcome the barriers associated with access to care, stigma, and social distancing. Although shown to be cost effective and efficacious in clinical trials and real-world evidence studies, respectively, information on its value for money from a health utilities and cost per quality-adjusted life-year is needed to inform policy discussions.Objectives: To evaluate the impact of reSET-O on health utilities and assess its overall cost per quality-adjusted life year (QALY) gained vs. treatment-as-usual (TAU).Methods: Decision analytic model comparing reSET-O plus TAU to TAU alone (i.e. buprenorphine, face-to-face counseling, and contingency management) over 12 weeks. Clinical effectiveness data (abstinence and health utility) were obtained from a clinical trial, and resource utilization and cost data were adapted from a recent claims data analysis to reflect less frequent face-to-face counseling with the therapeutic.Results: The addition of reSET-O to TAU decreases total health care costs by -$131 and resulted in post-treatment utility values within population norms, with a corresponding gain of 0.003 QALYs. reSET-O when used adjunctively to TAU was economically dominant (less costly, more effective) vs. TAU alone.Conclusion: reSET-O is an economically-dominant adjunctive treatment for OUD and is associated with an overall reduction in total incremental cost vs TAU. |
| Databáze: | OpenAIRE |
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