Is ED-Initiated Buprenorphine for Opioid Dependence Cost Effective?

Yale researchers analyzed ED-initiated buprenorphine, referral alone and brief intervention with facilitated referral
Yale researchers analyzed ED-initiated buprenorphine, referral alone and brief intervention with facilitated referral

Emergency department (ED)-initiated buprenorphine was the most cost-effective method for those with an untreated opioid addiction, according to a new Yale study published in the journal Addiction that assessed 3 approaches for treating patients who screen positive for opioid addiction.

Along with ED-initiated buprenorphine, the researchers analyzed the cost effectiveness of referral alone (community-based treatment) and brief intervention with facilitated referral. Results showed that the mean costs over the next 30 days after ED visits were $1,752, $1,805, and $1,977 for ED-initiated buprenorphine, brief intervention, and referral, respectively. Additionally, the ED-initiated buprenorphine group were found to be almost twice as likely to be enrolled in addiction treatment and use less illicit opioids as the other 2 groups.

The authors stated that their findings were robust in a range of secondary analyses. “Even under the most conservative assumptions about willingness-to-pay (ie, that willingness-to-pay is zero), we find ED-initiated buprenorphine is most likely to be cost effective among treatments studied,” they wrote.

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The authors cite how roughly just 1 in 5 individuals who needed treatment for opioid addiction received it in the past year (Park-Lee, E. et al. 2016) and less received buprenorphine. A similarly designed study should be initiated in other EDs to provide further data surrounding the benefits of initiating buprenorphine.

“We were excited to learn that not only was ED-initiated buprenorphine more effective in engaging patients in treatment, but it was cost-effective,” said senior author Gail D'Onofrio, MD. “All insurance payers and healthcare systems should be interested in these results.”

For more information visit wiley.com.