DIRECT HEALTHCARE COSTS FOR THE MANAGEMENT OF PATIENTS WITH OPIOID USE DISORDER TREATED WITH METHADONE AND BUPRENORPHINE/NALOXONE IN REAL-WORLD SETTING IN SPAIN. COSTEDOPIA STUDY
Author(s)
Roncero C1, Dorado ML2, Orengo T3, Ortega R4, Palma-Álvarez R5, Muñoz Á6, Casado MA7, Grau-López L5, Ahuir J8
1University of Salamanca, Pozuelo de Alarcon, M, Spain, 2Hospital General Universitario de Valencia, Valencia, Spain, 3Hospital Clínico Universitario de Valencia, Valencia, Spain, 4Hospital General Universitario Santa Lucía de Cartagena, Murcia, Spain, 5Vall d’Hebron University Hospital, Barcelona, Spain, 6Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, M, Spain, 7Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain, 8Indivior España S.L, Madrid, Spain
Presentation Documents
OBJECTIVES : To evaluate the economic impact in patients with Opioid Use Disorder (OUD) treated with methadone or buprenorphine/naloxone (B/N) in routine clinical practice in Spain. METHODS : COSTEDOPIA was a observational, retrospective and real-world study. Adult patients, diagnosed with OUD according to the Diagnostic and Statistical Manual of Mental Disorders DSM-IV/5, with at least 12 months with the same treatment methadone or B/N were included in the analysis. The direct healthcare cost (hospitalizations, visits to specialists, medical tests and concomitant medication) estimated included the costs of comorbidities, relapses, overdoses and dependence per se associated with OUD. RESULTS A total of 203 patients (102 treated with methadone and 101 with B/N) were included in the analysis. No significant differences were found in age, sex, education level or psychiatric comorbidities within the groups. There were more relapses in the methadone group (p=0.02). In B/N group, the relapsers had a lower mean dose (6.60 mg/day) compared with no-relapsers (mean dose 9.82 mg/day) (p=0.040). No statistically significant difference in the mean dose of methadone in relapsers Vs. no relapsers. Total direct healthcare cost per patient was €3,007.04 for methadone and €2,556.75 for B/N (cost savings €450.29; p-value=0.107). There were statistically significant differences between the treatment groups in the costs per patient related to the dependence per se associated with OUD (€1,315.27 with methadone and €885.47 with B/N; cost savings €429.80; p-value=0.026). The results show that there were no significant differences in the cost per patient of comorbidities management (€1,457.42 with methadone and €1,377.37 with B/N; cost savings €80.05; p-value=0.934). CONCLUSIONS Patients with OUD are characterized by the severity of their complications, by frequent poly drugs use and co-occurrent psychiatric and other comorbidities. In a real-world setting, treatment of OUD patients with B/N results in direct healthcare cost savings, compared to methadone.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PMH70
Disease
Mental Health