Novartis Division, Sandoz, Inc, Princeton, NJ, USA.
Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.
J Med Econ. 2021 Jan-Dec;24(1):61-68. doi: 10.1080/13696998.2020.1858581.
reSET-O is a Food and Drug Administration-cleared prescription digital therapeutic (PDT) indicated to improve outpatient-treatment retention of patients with opioid use disorder (OUD). This study examined the cost-effectiveness and budget impact of reSET-O in conjunction with treatment as usual (reSET-O + TAU) relative to TAU.
Adult patients with ≥1 OUD diagnosis, treated with buprenorphine from 1 January 2015 to 30 March 2018, were identified from Truven Health MarketScan Commercial and Medicare Supplemental Research Databases. Twelve-week healthcare resource utilization (HCRU) costs for patients categorized as adherent and nonadherent to buprenorphine treatment were estimated. Total 12-week costs included OUD treatment and other HCRU costs. The cost-effectiveness of reSET-O + TAU was modeled in accordance with prior clinical trial outcomes. The 12-week budget impact of reSET-O was modeled for a 1 million-member healthcare plan.
Higher buprenorphine adherence was associated with lower HCRU costs in claims data. Twelve-week per-patient total costs were $305 more for those receiving reSET-O + TAU than those receiving TAU. The incremental cost-effectiveness ratio was $18.70 per 1 percentage-point increase in the treatment retention rate. The probability that reSET-O + TAU would be considered cost-effective was over 92% for willingness-to-pay thresholds of $6,000 or more. The 12-week budget impact of reSET-O was $8,908, translating to $0.003 per member per month.
The findings of the cost-effectiveness and budget impact modeling are limited by the assumptions of the models due to uncertainty around some inputs. While no model is free of bias, the inputs for this model were carefully selected to reflect contemporary treatment patterns.
Depending on the payer's willingness to pay, reSET-O may be cost-effective in increasing buprenorphine treatment retention rates. reSET-O results in an approximate budget impact of $0.003 per member per month, depending on market share and the prevalence of the population receiving treatment for OUD.
reSET-O 是一种经美国食品和药物管理局批准的处方数字疗法（PDT），用于提高门诊治疗中阿片类药物使用障碍（OUD）患者的保留率。本研究评估了 reSET-O 联合常规治疗（reSET-O+TAU）相对于 TAU 的成本效益和预算影响。
从 Truven Health MarketScan 商业和 Medicare 补充研究数据库中，确定了 2015 年 1 月 1 日至 2018 年 3 月 30 日期间至少有 1 次 OUD 诊断且接受丁丙诺啡治疗的成年患者。根据患者对丁丙诺啡治疗的依从性，估算了 12 周的医疗资源利用（HCRU）成本。总 12 周成本包括 OUD 治疗和其他 HCRU 成本。根据先前临床试验结果，对 reSET-O+TAU 的成本效益进行建模。为 100 万成员的医疗保健计划建立了 reSET-O 的 12 周预算影响模型。
在索赔数据中，较高的丁丙诺啡依从性与较低的 HCRU 成本相关。接受 reSET-O+TAU 治疗的患者比接受 TAU 治疗的患者每例患者的 12 周总费用高出 305 美元。治疗保留率每增加 1 个百分点，增量成本效益比为 18.70 美元。当支付意愿阈值为 6000 美元或更高时，reSET-O+TAU 被认为具有成本效益的概率超过 92%。reSET-O 的 12 周预算影响为 8908 美元，相当于每个成员每月 0.003 美元。
由于某些输入存在不确定性，成本效益和预算影响建模的结果受到模型假设的限制。虽然没有模型是无偏见的，但该模型的输入是经过精心选择的，以反映当代的治疗模式。
根据支付方的支付意愿，reSET-O 可能具有成本效益，可以提高丁丙诺啡治疗的保留率。取决于市场份额和接受 OUD 治疗人群的流行程度，reSET-O 的预算影响约为每个成员每月 0.003 美元。
