Results varied somewhat by perspective. BUP cost providers approximately $1,514 more than DETOX per treatment episode in 2006 US dollars (p< 0.001), which translates into $25,049 per additional QALY (with no more than an 86% chance of being cost-effective at up to a $250,000 willingness-to-pay threshold) and $5,610 per additional opioid-free year (p < 0.001) assessed at year 1. For medical insurers, who benefitted from substantial savings on health care costs for those randomized to BUP, BUP cost $1,376/QALY (with only an 86% chance of being cost-effective) and $308/opioid-free year (p<0.001). The point estimate of $31,264 per patient suggests that societal cost savings from BUP may be substantial, but the difference between groups was not significant at conventional levels in part due to the large variance estimated for crime costs which, although the largest savings component at $26,224, were a reflection of infrequently reported high-cost crimes.
Results Article: Polsky D, et al. Cost-Effectiveness of Extended Buprenorphine-Naloxone Treatment for Opioid-Dependent Youth: Data from a Randomized Trial. Addiction 2010;105(9):1616-1624. [get article]