Objectives: To evaluate the cost-effectiveness of academic detailing outreach on naloxone prescribing among patients at-risk for an opioid-related overdose or death.

Methods: A decision tree model was constructed to evaluate the cost-effectiveness of academic detailing outreach across a time horizon of 1 year. Academic detailing is an educational outreach with the goal of aligning provider’s prescribing behavior with evidence-based practice. Using a U.S. payer perspective, we compared patients who received naloxone prescription from a provider who received or did not receive academic detailing outreach. The model simulated patients who experienced an opioid-related overdose that was witnessed or not witnessed; emergency services there were or not utilized; and lived or died from the overdose event. Costs for the naloxone prescription were based on the federal supply schedule; resource costs and utility scores were based on the existing literature. Costs were adjusted for 2021 $US. Total direct costs and quality-adjusted life years (QALYs) were estimated along with the incremental cost-effectiveness ratio (ICER). One-way sensitivity analyses were performed on all relevant parameters and visualized using a tornado diagram. Willingness to pay (WTP) threshold was set at $50,000 per QALY gained.

Results: Academic detailing was associated with a total direct cost of $1793 and 0.677 QALYs. The cohort that did not receive academic detailing was associated with a total direct cost of $1778 and 0.663 QALYs. In the deterministic model, the ICER was $1058 per QALY gained. Cost of naloxone was the most influential parameter; however, it did not change our base-case results. Moreover, the model was robust to the remaining one-way sensitivity analyses.

Conclusions: Academic detailing is a cost-effective strategy at a WTP threshold of $50,000 per QALY gained. Decision makers seeking to address the opioid epidemic may find that implementing academic detailing would be a cost-effective strategy based on our findings.