Cost of pharmacotherapy for opioid use disorders following inpatient detoxification

Kathryn E. McCollister, Jared A. Leff, Xuan Yang, Joshua D. Lee, Edward V. Nunes, Patricia Novo, John Rotrosen, Bruce R. Schackman, Sean M. Murphy

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: To estimate the costs of providing extended-release injectable naltrexone (XR-NTX) and buprenorphine-naloxone (BUP-NX) following inpatient detoxification using data derived from a multisite randomized controlled trial at 8 US community-based treatment programs.

STUDY DESIGN: Cost data were collected for 3 intervention phases: program start-up, inpatient detoxification, and up to 24 weeks of medication induction and management visits (post detoxification). Cost analyses were from the healthcare sector perspective (2015 US$); patient costs are also reported.

METHODS: We conducted site visits, administered a cost survey to treatment programs, and analyzed study data on medication and services utilization. Nationally representative sources were used to estimate unit costs. Uncertainty was evaluated in sensitivity analyses.

RESULTS: Mean start-up costs were $1071 per program for XR-NTX and $828 per program for BUP-NX. Mean costs per participant were $5416 for XR-NTX (57% detoxification, 37% medication, 3% provider, 3% patient) and $4148 for BUP-NX (64% detoxification, 12% medication, 10% provider, 14% patient). Total cost per participant ranged by site from $2979 to $8963 for XR-NTX and from $2521 to $6486 for BUP-NX.

CONCLUSIONS: For treatment providers, offering XR-NTX and/or BUP-NX as part of existing detoxification treatment modalities generates modest costs in addition to the costs of detoxification, which vary substantially among the 8 sites. From the patient's perspective, the costs associated with medication management visits may be a barrier for some individuals considering these treatments.

Original languageEnglish (US)
Number of pages6
JournalAmerican Journal of Managed Care
Issue number11
StatePublished - Nov 2018


  • Analgesics, Opioid/administration & dosage
  • Buprenorphine, Naloxone Drug Combination/administration & dosage
  • Costs and Cost Analysis
  • Delayed-Action Preparations
  • Humans
  • Injections, Intramuscular
  • Narcotic Antagonists/administration & dosage
  • Opioid-Related Disorders/drug therapy
  • Recurrence
  • United States

ASJC Scopus subject areas

  • Health Policy


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