Economic Evaluation in Opioid Modeling: Systematic Review

26 Pages Posted: 27 May 2020

See all articles by Elizabeth Beaulieu

Elizabeth Beaulieu

Harvard University - Harvard Medical School

Catherine DiGennaro

Massachusetts General Hospital

Erin Stringfellow

Harvard University - Harvard Medical School

Ava Connolly

Harvard College

Ava Hamilton

Columbia University - Mailman School of Public Health

Ayaz Hyder

College of Public Health, The Ohio State University

Magdalena Cerda

New York University (NYU) - New York University

Katherine M. Keyes

Columbia University

Mohammad S. Jalali

Harvard University - Harvard Medical School

Date Written: April 27, 2020

Abstract

Background: The opioid crisis is a complex problem associated with significant economic costs for healthcare systems and society. Simulation models have been developed to understand its complexity and to evaluate the potential costs of different strategies to address this problem.

Methods: A systematic review of simulation-based economic evaluation (SBEE) studies in opioid research was initiated by searches in PubMed, EMBASE, and EbscoHOST. Extraction of a pre-defined set of items and a quality assessment were performed for each study.

Results: The screening process resulted in 23 SBEE studies ranging by year of publication from 1999 to 2019. Methodological quality of the cost analyses was moderately high. The most frequently evaluated strategies were methadone and buprenorphine maintenance treatments; the only harm reduction strategy explored was naloxone distribution. These strategies were consistently found to be cost-effective, especially naloxone distribution and methadone maintenance. Prevention strategies were limited to abuse-deterrent opioid formulations. Most analyses (78%) assessed the cost-utility or cost-effectiveness of two or more interventions. Less than half (39%) adopted a societal perspective in their estimation of costs and effects from an opioid-related intervention. Consideration of patient and physician preference, changing costs, result stratification, or prevention was infrequent. High heterogeneity in study designs and outcomes precluded a meta-analysis.

Conclusions: The review shows consistently favorable cost analysis findings for naloxone distribution strategies and opioid antagonist treatments (methadone or buprenorphine maintenance treatments against no naloxone distribution and no treatment, respectively). The review observes gaps in accounting for patient and physician preferences or major changes in medication prices.

Suggested Citation

Beaulieu, Elizabeth and DiGennaro, Catherine and Stringfellow, Erin and Connolly, Ava and Hamilton, Ava and Hyder, Ayaz and Cerda, Magdalena and Keyes, Katherine M. and Jalali, Mohammad S., Economic Evaluation in Opioid Modeling: Systematic Review (April 27, 2020). Available at SSRN: https://ssrn.com/abstract=3587617 or http://dx.doi.org/10.2139/ssrn.3587617

Elizabeth Beaulieu

Harvard University - Harvard Medical School ( email )

25 Shattuck St
Boston, MA 02115
United States

Catherine DiGennaro

Massachusetts General Hospital ( email )

55 Fruit Street Boston
Boston, MA 02114
United States

Erin Stringfellow

Harvard University - Harvard Medical School ( email )

25 Shattuck St
Boston, MA 02115
United States

Ava Connolly

Harvard College ( email )

Cambridge, MA 02138
United States

Ava Hamilton

Columbia University - Mailman School of Public Health ( email )

600 West 168th St., 6th Floor
New York, NY 10032
United States

Ayaz Hyder

College of Public Health, The Ohio State University ( email )

OH
United States
6142474936 (Phone)

HOME PAGE: http://https://cph.osu.edu/people/ahyder

Magdalena Cerda

New York University (NYU) - New York University ( email )

Bobst Library, E-resource Acquisitions
20 Cooper Square 3rd Floor
New York, NY 10003-711
United States

Katherine M. Keyes

Columbia University ( email )

3022 Broadway
New York, NY 10027
United States

Mohammad S. Jalali (Contact Author)

Harvard University - Harvard Medical School ( email )

101 Merrimac St
Suite 1010
Boston, MA 02114
United States

HOME PAGE: http://scholar.harvard.edu/jalali

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