Originally published by our sister publication Pain Medicine News
By Myles Starr
Data from a recent study indicate that further extension of COVID-19 pandemic–era prescribing rules, referred to as “Notice of Proposed Rulemaking” (NPRM), would better treat patients suffering from opioid use disorder (OUD) and be more cost-effective than reverting to prepandemic regulations.
Last year the Drug Enforcement Administration, in collaboration with the Department of Health and Human Services, temporarily extended the authorization of all registered practitioners to prescribe Schedule II to V controlled medications via telemedicine and increased the number of pills that patients are allowed to be prescribed through Dec. 31, 2024.
“Buprenorphine and methadone OUD treatment under NPRM are likely to be effective and cost-effective,” study investigators noted.
To reach these conclusions, the researchers created a model-based analysis of buprenorphine and methadone treatment for a cohort of 100,000 individuals with OUD (Drug Alcohol Depend 2024:256:111112). They then applied varying treatment retention and overdose risk among models among individuals receiving and not receiving treatment under updated prescribing rules.
The researchers estimated that for buprenorphine treatment, 1.21 quality-adjusted life-years (QALYs) would be gained at a cost of $19,200 per QALY gained under the current NPRM guidelines when compared with no treatment. That cost would be further reduced to $18,900 per QALY gained if the retention rate in treatment were to increase by 20%. For methadone treatment under NPRM, 1.11 QALYs would be gained at a cost of $17,900 per QALY gained compared with no treatment. In all scenarios, methadone provision costs less than $20,000 per QALY gained compared with no treatment.
The investigators concluded that the increased overdose risk with take-home methadone may reduce health benefits; however, clinical and technological strategies could mitigate such risk.