Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
Through improved adherence, once-monthly injectable extended-release naltrexone (XR-NTX) may provide an advantage over other oral agents approved for alcohol and opioid dependence treatment. The objective of this study was to evaluate cost and utilization outcomes between XR-NTX and other pharmacotherapies for treatment of alcohol and opioid dependence. Published studies were identified through comprehensive search of two electronic databases. Studies were included if they compared XR-NTX to other approved medicines and reported economic and healthcare utilization outcomes in patients with opioid or alcohol dependence. We identified five observational studies comparing 1,565 patients using XR-NTX to other therapies over 6 months. Alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone. Healthcare utilization and costs was generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.
Oregon State University/Oregon Health & Science University College of Pharmacy, 3303 SW Bond Avenue, CH12C, Portland OR 97239. Electronic address: hartungd@ohsu.edu.
Daniel M
DM
Hartung
Department of Public Health and Preventive Medicine, Oregon Health & Science University, CB669, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
Dennis
D
McCarty
Department of Public Health and Preventive Medicine, Oregon Health & Science University, CB669, 3181 SW Sam Jackson Park Road, Portland, OR 97239.
Rongwei
R
Fu
CODA, 1027 E. Burnside St., Portland, OR 97214.
Katharina
K
Wiest
Treatment Research Institute, Public Ledger Building, Philadelphia, PA 19106.
Mady
M
Chalk
Alkermes, Inc., 852 Winter Street, Waltham, MA 02451.
David R
DR
Gastfriend
D000437:Alcoholism / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D017048:Health Care Costs; D006801:Humans; D055118:Medication Adherence; D009271:Naltrexone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000191:economics
D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone
Alcohol dependence; Naltrexone; Opioid dependence