COST-EFFECTIVENESS OF A LOW-THRESHOLD MOBILE MEDICAL UNIT PROVIDING OPIOID USE DISORDER CARE IN AN URBAN SETTING
Author(s)
Kanya K. Shah, MBA, MS, PharmD1, Melanie D. Whittington, MS, PhD2, Sarah E Messmer, MD3, Angela Kong, PhD, MPH, RDN1, Lisa K. Sharp, BA, MA, PhD4, Daniel R. Touchette, MA, PharmD1.
1Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois Chicago, Chicago, IL, USA, 2Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA, 3Department of Medicine and Institute for Research on Addictions, University of Illinois Chicago, Chicago, IL, USA, 4Department of Biobehavioral Nursing Science, University of Illinois at Chicago, Chicago, IL, USA.
1Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois Chicago, Chicago, IL, USA, 2Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA, USA, 3Department of Medicine and Institute for Research on Addictions, University of Illinois Chicago, Chicago, IL, USA, 4Department of Biobehavioral Nursing Science, University of Illinois at Chicago, Chicago, IL, USA.
OBJECTIVES: Low-threshold mobile units provide medication treatment for opioid use disorder (MOUD) to communities in need. We evaluated the addition of a mobile unit to traditional clinics for delivering MOUD to patients with opioid use disorder (OUD) from the US healthcare-sector perspective, estimating that mobile units would reach an additional 2.5% of the population who would otherwise not receive treatment in a traditional clinic.
METHODS: A Markov model, informed by published literature, national surveys, and previous models, estimated the costs and outcomes of a population with OUD accessing MOUD over a lifetime horizon, with one-month cycles, and a 3% discount rate. Health states combined using or not using MOUD and using or not using illicit opioid substances; opioid-related overdoses were incorporated as transient events. Individuals entered the model either on or off treatment, and the prevalence of MOUD use was informed by national estimates of MOUD utilization. Mobile unit costs were sourced from a primary cost analysis of an operating MOUD mobile unit in Chicago. Outcomes were total costs, life-years (LYs), and quality-adjusted life-years (QALYs).
RESULTS: Compared with traditional clinics ($49,700 and 19.0 QALYs), the addition of mobile units resulted in a total cost of $57,300 and 22.0 QALYs. The incremental total cost of $7,600 was attributed to medication and healthcare costs associated with increased access to MOUD. Furthermore, with access to the mobile unit, the average population with OUD lived an additional 3.7 LYs, with 3.0 QALYs gained, for an incremental cost-effectiveness ratio (ICER) of $2,500/QALY.
CONCLUSIONS: Increasing MOUD access through mobile units, in addition to traditional clinics, was cost-effective at commonly accepted willingness-to-pay thresholds, compared to traditional clinics alone. Given that mobile units target communities with high need, future research will examine the differential impact of mobile units among equity-relevant subgroups.
METHODS: A Markov model, informed by published literature, national surveys, and previous models, estimated the costs and outcomes of a population with OUD accessing MOUD over a lifetime horizon, with one-month cycles, and a 3% discount rate. Health states combined using or not using MOUD and using or not using illicit opioid substances; opioid-related overdoses were incorporated as transient events. Individuals entered the model either on or off treatment, and the prevalence of MOUD use was informed by national estimates of MOUD utilization. Mobile unit costs were sourced from a primary cost analysis of an operating MOUD mobile unit in Chicago. Outcomes were total costs, life-years (LYs), and quality-adjusted life-years (QALYs).
RESULTS: Compared with traditional clinics ($49,700 and 19.0 QALYs), the addition of mobile units resulted in a total cost of $57,300 and 22.0 QALYs. The incremental total cost of $7,600 was attributed to medication and healthcare costs associated with increased access to MOUD. Furthermore, with access to the mobile unit, the average population with OUD lived an additional 3.7 LYs, with 3.0 QALYs gained, for an incremental cost-effectiveness ratio (ICER) of $2,500/QALY.
CONCLUSIONS: Increasing MOUD access through mobile units, in addition to traditional clinics, was cost-effective at commonly accepted willingness-to-pay thresholds, compared to traditional clinics alone. Given that mobile units target communities with high need, future research will examine the differential impact of mobile units among equity-relevant subgroups.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE24
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas