title: Cost-Effectiveness of Injectable Extended-Release Naltrexone Compared With Methadone Maintenance and Buprenorphine Maintenance Treatment for Opioid Dependence.
abstract: BACKGROUND
  The aim of this study was to estimate the cost-effectiveness of injectable extended-release naltrexone (XR-NTX) compared with methadone maintenance and buprenorphine maintenance treatment (MMT and BMT, respectively) for adult males enrolled in treatment for opioid dependence in the United States from the perspective of state-level addiction treatment payers.
  
  
  METHODS
  A Markov model with daily time cycles was used to estimate the incremental cost per opioid-free day in a simulated cohort of adult males aged 18-65 over a 6-month period from the state health program perspective.
  
  
  RESULTS
  XR-NTX is predicted to be more effective and more costly than methadone or buprenorphine in our target population, with an incremental cost per opioid-free day gained relative to the next-most effective treatment (MMT) of $72. The cost-effectiveness of XR-NTX relative to MMT was driven by its effectiveness in deterring opioid use while receiving treatment.
  
  
  CONCLUSIONS
  XR-NTX is a cost-effective medication for treating opioid dependence if state addiction treatment payers are willing to pay at least $72 per opioid-free day.
authors.affiliation: a Department of Population Health Sciences , University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , USA.
authors.forename: Heide
authors.initials: H
authors.lastname: Jackson
authors.forename: Kara
authors.initials: K
authors.lastname: Mandell
authors.forename: Kimberly
authors.initials: K
authors.lastname: Johnson
authors.forename: Debanjana
authors.initials: D
authors.lastname: Chatterjee
authors.forename: David J
authors.initials: DJ
authors.lastname: Vanness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002047:Buprenorphine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D016527:Drug Costs / Q000706:statistics & numerical data*; D006801:Humans; D007267:Injections / Q000191:economics; D008297:Male; D008390:Markov Chains; D008691:Methadone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000191:economics*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000191:economics*; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D002047:Buprenorphine; D009271:Naltrexone; D008691:Methadone
keywords: Cost-effectiveness; XR-NTX; opioid dependence