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ED-initiated medication is cost-effective for untreated opioid addicts

Social & Preventive Medicine / Community Medicine

Researchers from Yale found that buprenorphine was the most cost-effective treatment for untreated opioid addicts visiting emergency departments (ED). Buprenorphine reduced drug craving and withdrawal. It was also found to be effective ED-initiated medication strategy compared to referrals.

In a previous analysis of this study, Yale researchers compared the ED-initiated buprenorphine and a referral for ongoing treatment in opioid addiction. Treatment with buprenorphine was found to be more effective than the standard referral or brief intervention with the referral.

In the current study, published in the journal Addiction , the researchers compared the relative cost and value of these approaches for individuals positive for opioid addiction. It included referral alone, brief intervention with the facilitated referral, and ED-initiated buprenorphine. The cost of health care for such patients including the ED visit and care over 30 days after the visit was estimated and compared, the costs included ED care, addiction treatment, inpatient and outpatient costs, and medications.

ED-initiated buprenorphine was found to be the most cost-effective treatment, with a mean cost of $ 1,752 compared with $ 1,805 for brief intervention and $ 1,977 for the referral. The group treated with buprenorphine was approximately two times as likely to be enrolled in addiction treatment and used opioids for some days during the month after the ED visit.

Susan Busch, the professor at the Yale School of Public Health said, "On average the costs were lowest in the ED-Buprenorphine group." These patients showed better outcomes despite not using additional health care resources.

Senior author Gail D'Onofrio, MD said that they were excited to learn ED-initiated buprenorphine to be more effective as well as cost-effective . "All insurance payers and healthcare systems should be interested in these results," he added.

"We know that the epidemic has devastating consequences for individuals, but many people are not in treatment," said Busch. "This is one high-value, effective way to get people the help they need."