Health care costs for treating opioid addiction are not just isolated to the expense of the drug.
Researchers have found that using the drug diacetylmorphine instead of methadone results in longer life expectancy and lower relapse rates.
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Bohdan Nosyk PhD., from the Centre for Health Evaluation and Outcome Sciences in Vancouver, British Columbia, ran a study to evaluate whether a new drug would be as cost effective as methadone in the treatment of opioid addiction.
Diacetylmorphine is the active ingredient in heroin and it can be injected to help manage opioid addiction. While methadone does help people trying to kick a heroin habit, relapse rates are high. The cost per dose of diacetylmorphine is higher than that of methadone, but the cost per dose is not the only issue when treating heroin addiction.
Researchers factored in treatment, relapse rates, and factors of HIV infection when determining which drug was cheaper overall. They looked at cost ratios at 1-, 5-, 10-year and lifetime periods.
Patients on methadone: “generated a societal cost of $1.14 million”. Patient on diacetylmorphine: “generated a societal cost of $1.10 million.” The number one factor for the reduction in cost had to do with a reduction in criminal activity associated with heroin use.
The study also estimated that the quality-of-life-years (QALYs) would be greater for the group on diacetylmorphine.
Authors state: “Our model indicated that diacetylmorphine would decrease societal costs, largely by reducing costs associated with crime, and would increase both the duration and quality of life of treatment recipients.
"Because opioid users commit less crime and have lower rates of health care use and death while in treatment, the benefits in cost and health utility attributable to diacetylmorphine stemmed chiefly from its capacity to retain patients in treatment for longer periods than with methadone maintenance treatment.”
According to the study, an estimated 15-25 percent of opioid addicts do not stick with methadone treatment. While the cost of diacetylmorphine could be as much as 10 times greater than conventional methadone treatments, lower contraction rates of HIV and hepatitis C and lower criminal justice expenses could greatly offset the drug investment costs.
Authors estimate that costs related to criminal activity accounted for 77-81 percent of lifetime costs for heroin addicts.
This study was published in the Canadian Medical Association Journal, April 2012. Funding for the North American Opiate Medication Initiative was supported by grants from the Canadian Institutes of Health Research, the Canadian Foundation for Innovation, the Canada Research Chairs Program, the University of British Columbia, Providence Health Care, Universite de Montreal, Centre de recherché et d’aide pour narcomanes, the Government of Quebec, Vancouver Coastal Health and the BC Centre for Disease Control.
Authors Suzanne Brissette and David Marsh have received consulting and lecture fees from Schering-Plough. No conflicts of interest were found.