Cost-effectiveness analysis of maintenance agonist treatments in the NEPOD.
A total of 551 participants were randomized to treatment in three heroin-dependence treatment trials participating in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) project. A total of 272 patients (49%) received methadone maintenance, 238 (43%) received buprenorphine maintenance and 41 (7%) participants received levo-alpha-acetyl-methadol (LAAM). A total of 63% of participants in the methadone maintenance group were in treatment in the third month, with an average treatment episode lasting 69 days. This compares with 51% of participants in the buprenorphine maintenance group with an average treatment episode of 60 days and 71% of participants in the LAAM group with an average treatment episode of 75 days. The results of the cost-effectiveness analysis suggested that, for the primary outcome measure of imputed change in heroin-free days, compared with methadone maintenance, LAAM was the most cost-effective treatment, followed by buprenorphine maintenance. No statistically significant differences were found in the cost-effectiveness of methadone maintenance, buprenorphine maintenance and LAAM. Given the limited information available regarding the relative cost-effectiveness of pharmacotherapies for opioid maintenance treatment, the data reported herein provide valuable information to policy makers and treatment providers.
Doran
Christopher M
CM
Associate Professor, Health Economist, University of Queensland, School of Population Health, School of Economics, Mayne Medical School, Herston Road, Herston 4006, QLD, Australia. c.doran@sph.uq.edu.au.
Shanahan
Marian
M
Digiusto
Erol
E
O'Brien
Susannah
S
Mattick
Richard P
RP