title: Economic impact of a novel naloxone autoinjector on third-party payers.
abstract: BACKGROUND
  Patient overdoses on prescription opioid analgesics in the United States continue to rise, resulting in increased emergency department and hospitalization costs. Opioid overdose is readily reversible with naloxone, a fast-acting opioid antagonist. A new naloxone autoinjector (NAI), Evzio, which does not require medical training to use, was approved by the FDA in April 2014. Payers must decide on reimbursement policies for this product.
  
  
  OBJECTIVE
  To demonstrate to payer decision makers the costs and potential medical resource cost offsets associated with the utilization of a new NAI.
  
  
  METHODS
  A deterministic model using matched controls.
  
  
  METHODS
  An Excel-based cost model was developed for a hypothetical health plan with 1 million adult members. Costs of prescription opioid overdose events for patients appropriately dispensed NAI were compared with matched controls.
  
  
  RESULTS
  NAI prescriptions increased from 218 in Year 1 to 2,527 in Year 3. In Year 3, 86 NAI patients (and their matched controls) experienced opioid overdose events. For this period, fatal overdoses in the NAI cohort totaled 11.1 vs. 14.7 for the control group. In Year 3, 2.5 deaths (10.1-7.6) were avoided. NAI acquisition costs rose from $125,000 in Year 1 (PMPM = $0.01) to nearly $1.5 million in Year 3 (PMPM = $0.12).This cost was offset by medical resource savings of approximately $84,000 in Year 1, increasing to $975,000 in Year 3. The total net cost (NAI less offsets) in Year 3, when NAI uptake was assumed to plateau, was $481,000 (PMPM = $0.04).
  
  
  CONCLUSIONS
  A deterministic model demonstrated that NAI acquisition costs can be offset through medical cost reductions with improved timely access to naloxone.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Weiss
authors.forename: Gary R
authors.initials: GR
authors.lastname: Bazalo
authors.forename: Heather
authors.initials: H
authors.lastname: Thomson
authors.forename: Eric
authors.initials: E
authors.lastname: Edwards
mesh_terms: D006801:Humans; D007349:Insurance, Health, Reimbursement; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D012646:Self Administration / Q000191:economics / Q000295:instrumentation*; D014481:United States
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone