Currently, Methadone (opioid agonist treatment for opioid dependent people) prescription in France is allowed only for hospital physicians working in specialized healthcare centers. In the last 20 years, many French experts have requested the ability for General Practitioners (GPs) to prescribe methadone, to improve patient’ care and management as it is already the case for buprenorphine.

OBJECTIVES:

The objective of the study was to demonstrate the economic impact for the French Healthcare insurance of the authorization to describe methadone given to GPs in addition to hospital physicians.

METHODS:

A Budget impact analysis (BIA) was conducted to demonstrate the financial difference between the current scenario (1) and a new scenario (2) integrating the authorization of methadone prescription by GPs as of January 1, 2018

RESULTS:

- The study showed cost savings could be generated by a gradual transfer from health centers to general practices, as GP’s annual cost is three times less expensive than health centers annual cost

- Despite a lower price of Methadone, the scenario 2 will lead to additional expenses induced by a broader access to the treatment

- Savings are also generated by the fact that a large number of patients treated under scenario 2 are less likely to be infected by HCV or HIV.

CONCLUSIONS:

Allowing GPs to prescribe methadone would lead to significant cost savings for the French Health insurance, around €40 million between 2018 and 2022.

Besides, it would extend the access of opioid substitution treatment (OST) adapted for injecting drug users and/or nonresponders to another OST.