Buprenorphine for opiate addiction: potential economic impact

This study evaluated the potential economic impact of the buprenorphine/nal oxone combination in the context of practice in the United States of Americ a. In comparison to treatment provided through methadone clinics. buprenorp hine/naloxone therapy in office practice may be associated with increased m edication, physician, and nursing costs. but reduced costs for dispensing, toxicology screens. counseling and administration. It may also result in ma rkedly reduced costs for patients, especially travel costs, resulting in ne t savings for society as a whole. A review of controlled studies suggest th at buprenorphine/naloxone is not likely to be any more or less effective th an methadone, but since it will be less expensive in the long run, it may b e more cost-effective than methadone when provided to comparable groups of patients. Because of the convenience of office-based treatment, buprenorphi ne/naloxone may increase access to opiate substitution for some addicts. To the extent that treatment is provided to additional high-cost patients who are involved in extensive criminal activity or who undergo multiple detoxi fications each year, net cost savings could be substantial. To the extent t hat treatment is extended to better adjusted addicts who are employed, marr ied and experience Fewer adverse effects from their addiction. costs could increase. The total cost impact will depend on which addict sub-populations make greatest use of the treatment opportunity presented by buprenorphine/ naloxone, (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.