Cost-effectiveness of opioid substitution treatment (OST)

Economic evaluations of the pharmacological treatment of opioid use disorder were analysed in a narrative systematic review (Onuoha et al., 2021, studies = 21 - 4 cost-offset studies and 17 cost-effectiveness/cost-benefit studies) that found:

• strengthened evidence on the cost-effectiveness of buprenorphine and methadone, indicating that these treatments are both economically advantageous compared with no pharmacotherapy (no evidence was found supporting superior economic value between the two medications)

Four studies focused on the potential reductions in healthcare costs associated with pharmacological treatment of opioid use disorders and found that OST leads to lower healthcare resource utilization and expenditures than nonpharmacologic therapies. Also results from one population-level study indicate significantly lower criminal justice–related costs among participants who received methadone compared with those who received detoxification only.

Further economic research is needed on Naltrexone, as well as other emerging pharmacotherapies, treatment modalities, and dosage forms.