OBJECTIVES: To estimate the price at which CAM2038 would achieve commonly cited cost-effectiveness (CE) thresholds when treating persons with opioid use disorder (OUD).

METHODS: We developed a de novo Markov model comparing CAM2038, an investigational form of extended-release subcutaneous (SC) buprenorphine/naloxone to generic sublingual (SL) buprenorphine/naloxone in adults diagnosed with OUD and considered for treatment with medications for addiction treatment (MAT). The model uses a U.S. health care sector perspective over a five-year time horizon with four-week cycles, with costs and outcomes discounted at 3% annually. The model comprised five health states: “MAT with Illicit Use of Opioids”, “MAT with NO Illicit Use of Opioids”, “OFF MAT with Illicit Use of Opioids”, “OFF MAT with NO Illicit Use of Opioids” and “Death”. Data on treatment effectiveness i.e., abstinence from illicit use of opioids, and treatment discontinuation rates were sourced from CAM2038’s pivotal Phase III trial that compared it to SL buprenorphine/naloxone. Health state utilities were derived from a U.S. cross-sectional survey study. Costs included drug, drug administration and monitoring and non-drug health care costs, as applicable. In the absence of a price, using published evidence on its efficacy, we calculated the annual prices at which CAM2038 would achieve the $100,000 to $150,000 per quality-adjusted life year (QALY) CE thresholds.

RESULTS: Despite a higher rate of abstinence from illicit use of opioids when using CAM2038, only a marginal QALY gain, (3.26 vs. 3.20) was predicted due to its higher rate of discontinuation relative to generic SL buprenorphine/naloxone. CAM2038’s estimated annual price to achieve CE thresholds of $100,000 to $150,000 per QALY was between $4,100 and $5,300.

CONCLUSIONS: With only marginal clinical improvements relative to its comparator, treatment of OUD with CAM2038 would reflect long-term value for money only at annual prices no more than $2,300 above that of generic SL buprenorphine/naloxone ($3,000 per year).