Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial
Cost-effectiveness of extended buprenorphine-naloxone treatment for opioid-dependent youth: data from a randomized trial
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DOI：
10.1111/j.1360-0443.2010.03001.x
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发表时间：
2010-09-01
期刊：
影响因子：
6
通讯作者：
Woody, George E.
中科院分区：
文献类型：
--
作者：
Polsky, Daniel;Glick, Henry A.;Woody, George E.
AimsThe的目的是估计成本，净社会成本和成本效益的一项临床试验中延长丁丙诺啡-纳洛酮（BUP）治疗与阿片类药物依赖youth. Design短期戒毒治疗在2003年7月至2006年12月，谁被随机分配到12周的BUP或14天的锥度（DETOX）在6个社区门诊治疗方案进行的临床试验的经济评价。BUP患者的处方量为每天24 mg，持续9周，然后在第12周结束时逐渐减少至零。DETOX患者的处方量为每天14 mg，然后在第14天逐渐减少至零。152名年龄在15-21岁的患者在12周的治疗期间和6个月、9个月和12个月的随访中前瞻性地收集数据。结果12周的门诊研究治疗费用BUP比DETOX高1514美元（P < 0.001）。一年的直接医疗总费用仅为83美元，BUP（P = 0.97）。BUP相对于DETOX的成本-效果比在每质量调整生命年（QALY）的1年直接医疗成本方面为1376美元，在每QALY的门诊治疗计划成本方面为25049美元。可接受性曲线表明，BUP相对于DETOX的成本效益比有86%的机会被接受为具有成本效益的阈值为$100 000每QALY.ConclusionsExtended BUP治疗相对于简短的戒毒是具有成本效益的阿片类药物依赖青年的门诊治疗在美国的医疗保健系统。
AimsThe objective is to estimate cost, net social cost and cost-effectiveness in a clinical trial of extended buprenorphine-naloxone (BUP) treatment versus brief detoxification treatment in opioid-dependent youth.DesignEconomic evaluation of a clinical trial conducted at six community out-patient treatment programs from July 2003 to December 2006, who were randomized to 12 weeks of BUP or a 14-day taper (DETOX). BUP patients were prescribed up to 24 mg per day for 9 weeks and then tapered to zero at the end of week 12. DETOX patients were prescribed up to 14 mg per day and then tapered to zero on day 14. All were offered twice-weekly drug counseling.Participants152 patients aged 15-21 years.MeasurementsData were collected prospectively during the 12-week treatment and at follow-up interviews at months 6, 9 and 12.FindingsThe 12-week out-patient study treatment cost was $1514 (P < 0.001) higher for BUP relative to DETOX. One-year total direct medical cost was only $83 higher for BUP (P = 0.97). The cost-effectiveness ratio of BUP relative to DETOX was $1376 in terms of 1-year direct medical cost per quality-adjusted life year (QALY) and $25 049 in terms of out-patient treatment program cost per QALY. The acceptability curve suggests that the cost-effectiveness ratio of BUP relative to DETOX has an 86% chance of being accepted as cost-effective for a threshold of $100 000 per QALY.ConclusionsExtended BUP treatment relative to brief detoxification is cost effective in the US health-care system for the outpatient treatment of opioid-dependent youth.