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.
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.
Christopher M
CM
Doran
Marian
M
Shanahan
Erol
E
Digiusto
Susannah
S
O'Brien
Richard P
RP
Mattick