Treating Opioid Use Disorder With Methadone in Pharmacies

Area of Science:

• Pharmacology and Public Health
• Health Economics
• Pharmacy Practice

Background:

• Methadone is crucial for treating opioid use disorder but is underutilized in the US.
• Current federal law limits methadone dispensing primarily to Opioid Treatment Programs (OTPs).
• Pharmacy-based models could increase methadone access and improve overdose crisis response.

Purpose of the Study:

• To evaluate the financial viability and return on investment (ROI) of two pharmacy-based methadone dispensing models.
• To analyze the profitability of community pharmacies offering methadone services.

Main Methods:

• A cross-sectional economic evaluation comparing two models: a medication unit within a pharmacy and direct pharmacist dispensing.
• Models included startup and 3-year operational costs and revenues, using data from interviews, time-motion studies, and literature.
• 10,000 Monte Carlo simulations were performed to determine ROI ratios and net profits with 95% uncertainty intervals.

Main Results:

• The medication unit model yielded a 3-year ROI of $3.53 for every $1.00 spent, with a net profit of $96,904.
• The pharmacist-dispensed model showed a 3-year ROI of $2.64 for every $1.00 spent, with a net profit of $23,844.
• Both models demonstrated a high likelihood (over 93%) of achieving a $15,000 profit within 3 years.

Conclusions:

• Both evaluated pharmacy-based methadone models are financially profitable over three years.
• Increased access to methadone through pharmacies can be a viable business strategy.
• Potential regulatory changes could facilitate broader implementation of these pharmacy-based models.