Methadone, buprenorphine, or detoxification for management of perinatal opioid use disorder: A cost-effectiveness analysis
Obstetrics and Gynecology Nov 03, 2019
Premkumar A, et al. - Researchers compared the cost-effectiveness of methadone, buprenorphine, or detoxification treatment in the management of opioid use disorder (OUD) during pregnancy via creating a decision-analytic model. Using the existing literature, they determined probabilities, costs, and utilities. Calculation of incremental cost-effective ratios for each strategy was done, and cost-effectiveness was defined using a ratio of $100,000 per quality-adjusted life-years. They performed one-way sensitivity analyses and a Monte Carlo probabilistic sensitivity analysis. Findings revealed that under most circumstances, buprenorphine is estimated to be a cost-effective strategy when compared with either methadone or detoxification as a treatment for OUD during pregnancy. Nonetheless, the cost-efficacy of buprenorphine was not observed in almost one out of three simulations, indicating possibly limited robustness of the model and the necessity for further evaluation of the cost-effective approach to the management of OUD during pregnancy.
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