开发一种预算影响模型，以量化旨在防止滥用或便于提取的处方阿片类药物可能节省的成本。

Development of a budget-impact model to quantify potential cost savings from prescription opioids designed to deter abuse or ease of extraction.

作者信息

White Alan G, Birnbaum Howard G, Rothman Dov B, Katz Nathaniel

机构信息

Analysis Group, Inc., Boston, Massachusetts, USA.

出版信息

Appl Health Econ Health Policy. 2009;7(1):61-70. doi: 10.1007/BF03256142.

DOI:10.1007/BF03256142

PMID:19558195

Abstract

BACKGROUND

Prescription opioid (RxO) abuse, dependence and misuse is a significant and growing problem in the US, and is associated with a substantial economic burden. Such abuse may be reduced by theoretical formulations that minimize the possibility of abuse, dependence and misuse of RxOs by injection, snorting, crushing or chewing. As well as public health and safety benefits, use of an abuse-deterrent/resistant RxO (ADO) that may deter abuse, dependence and misuse could also generate cost savings.

OBJECTIVES

To estimate potential annual cost savings to US third-party payers realized from introducing a theoretical ADO.

METHODS

A budget-impact model (BIM) was developed to assess potential cost savings from the introduction of an ADO to third-party payers. The BIM included information on ADO attributes, costs associated with RxO abuse-related episodes, prevalence of RxO abuse and potential market share capture of the new ADO. Numbers of abuse-related episodes were calculated using a database on admissions to substance abuse treatment centres and other national surveys. Direct (medical and pharmaceutical) costs associated with RxO abuse, dependence and misuse were calculated using de-identified employer claims data (n > 6 000 000) for costs of abuse-related episodes. All cost estimates are in $US, year 2006 values. The BIM was developed for a theoretical prescription drug with therapeutic properties similar to those of controlled-release oxycodone, in a formulation that is specifically designed to resist or deter common methods of abuse, including injection, crushing, snorting and chewing.

RESULTS

Potential cost savings to third-party payers from introducing an ADO for the US (assuming a privately insured cost structure) could range from approximately $US0.6 billion to $US1.6 billion per year depending on different possible scenarios.

CONCLUSION

While savings estimates from introduction of an ADO depend on a range of assumptions, cost savings would be substantial.

摘要

背景

在美国，处方阿片类药物（RxO）滥用、依赖和误用是一个严重且日益严重的问题，并且与巨大的经济负担相关。通过理论配方将通过注射、吸食、碾碎或咀嚼方式滥用、依赖和误用RxO的可能性降至最低，此类滥用情况可能会减少。除了对公众健康和安全有益外，使用具有抗滥用/抗成瘾性的RxO（ADO）来防止滥用、依赖和误用还可能节省成本。

目的

评估引入理论上的ADO可为美国第三方支付方带来的潜在年度成本节省。

方法

开发了一个预算影响模型（BIM），以评估向第三方支付方引入ADO可能节省的成本。BIM纳入了有关ADO属性、与RxO滥用相关事件的成本、RxO滥用患病率以及新ADO的潜在市场份额获取等信息。使用药物滥用治疗中心入院数据库和其他全国性调查来计算与滥用相关事件的数量。使用去识别化的雇主索赔数据（n>6,000,000）计算与RxO滥用、依赖和误用相关的直接（医疗和药品）成本，以获取与滥用相关事件的成本。所有成本估计均以2006年美元价值计。BIM是针对一种理论上的处方药开发的，其治疗特性与缓释羟考酮相似，其配方专门设计用于抵抗或防止常见的滥用方法，包括注射、碾碎、吸食和咀嚼。