Cost-effectiveness of Extended Buprenorphine-Naloxone Treatment for Opioid-Dependent Youth: Data from a Randomized Trial

摘要: The standard of treatment for opioid dependent youth remains brief detoxification followed by counseling despite documented high relapse rates.1 While methadone maintenance is accepted as one the most effective treatments dependence, use agonists in adolescents limited. Reasons include availability to only those over 18 years age; daily visits specialized programs; concerns raised both providers and community about starting a on that often long-term with unknown consequences; reluctance bring young patients into contact older persons having extensive histories addiction antisocial behavior. Sublingual buprenorphine, schedule-III, mu-opioid receptor partial-agonist, may be an alternative acute management longer-term opioid-dependent youth.2,3 Buprenorphine particularly attractive adults because lower risk death from overdose fact it can prescribed licensed physicians including primary care their medical offices. Yet buprenorphine-naloxone (sold Suboxone® U.S.) expensive, which substantially limit access. Given cost-constrained environment, gaps private insurance coverage (generally specifically buprenorphine-naloxone), large role public funding this population, understanding cost-effectiveness buprenorphine critical addressing barriers. In what follows, we present data costs effects were observed trial compared more extended course short-term detoxification. We common clinical effectiveness measure, opioid-free urine, but also broaden definition patient’s quality life social consequences related its treatment.4–6 evaluated perspective payer health services (i.e. insurer), substance abuse outpatient program (i.e., provider), society. multiple perspectives provide insight not economic impact different stakeholders resulting buprenorphine-naloxone, benefits.