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Cost per Opioid-Free Year: A Systematic Review and Summary Analysis.

Babasoji E Oyemakinde1, Danielle Ryan1, Techna Cadet2

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Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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Economic evaluations of opioid use disorder (OUD) interventions commonly use cost per opioid-free year (OfY). This review establishes initial benchmarks for OfY cost-effectiveness, aiding future research and decision-making in OUD treatment.

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Area of Science:

  • Health Economics
  • Public Health
  • Addiction Medicine

Background:

  • Opioid use disorder (OUD) presents a significant public health crisis in the US.
  • Time free from opioid use is a key metric in economic evaluations of OUD interventions.
  • Establishing cost-effectiveness benchmarks is crucial for guiding OUD treatment decisions.

Purpose of the Study:

  • To review the economic evaluation literature on OUD interventions.
  • To identify studies calculating incremental cost-effectiveness ratios (ICERs) based on time free from opioids.
  • To establish a benchmark for cost per opioid-free year (OfY) in OUD treatment.

Main Methods:

  • Systematic review of economic evaluations of OUD interventions from inception to September 2024.
  • Extraction and normalization of ICERs to cost per opioid-free year (OfY) in 2024 USD.
  • Classification of studies by intervention location (US vs. international) and economic perspective.

Main Results:

  • Fourteen articles met inclusion criteria, with 8 from the US and 6 international.
  • US-based average ICERs per OfY: $243,053 (healthcare), $17,674 (state policymaker), $32,125 (societal).
  • International average ICERs per OfY: $79,765 (healthcare), $195,980 (societal).

Conclusions:

  • Cost per OfY is a vital metric for assessing OUD intervention effectiveness.
  • A universally accepted benchmark for cost per OfY in OUD treatment is currently lacking.
  • This review provides aggregated data to initiate the establishment of a cost-effectiveness threshold for OfY.