Velez Fulton F, Colman Sam, Kauffman Laura, Ruetsch Charles, Anastassopoulos Kathryn, Maricich Yuri A
Pear Therapeutics, Inc., Boston, MA, USA.
Covance Market Access, Gaithersburg, MD, USA.
Clinicoecon Outcomes Res. 2021 Oct 29;13:909-916. doi: 10.2147/CEOR.S334274. eCollection 2021.
A prescription digital therapeutic (PDT) (reSET-O) may expand access to behavioral treatment for patients with opioid use disorder (OUD) treated with buprenorphine, but long-term data on effectiveness are lacking.
To compare real-world healthcare resource utilization (HCRU) among patients who engaged with reSET-O and buprenorphine compared to similar patients in recovery treated with buprenorphine who did not fill their reSET-O script or engage with the PDT beyond week one.
A retrospective analysis of facility and clinical service claims data was conducted in adults with PDT initiation and between 12 weeks and 9 months of continuous enrollment in a health plan after initiation. Patients who filled their prescription and engaged with the therapeutic were compared to patients who filled the prescription but did not engage beyond week one (NE), and patients who did not fill the prescription (NR) (the latter two groups combined into one group hereafter referred to as "non-engagers"). Comparisons were analyzed using a repeated-measures negative binomial model of encounters/procedures, adjusted for number of days in each period. Associated cost trends assessed using current Medicare reimbursement rates.
A total of 444 patients redeemed a prescription and engaged with the PDT (mean age 37.5 years, 63.1% female, 84% Medicaid), and 64 patients did not engage with the PDT (mean age 39.5 years, 32.8% female, 73.4% Medicaid). Total cost of hospital facility encounters was $2693 for engaged patients vs $6130 for non-engaged patients. Engaged patients had somewhat higher rates of certain clinician services. Total facility and clinician services costs for engaged vs non-engaged patients were $8733 vs $11,441, for a net cost savings over 9 months of $2708 per patient who engaged with reSET-O.
Patients who engaged with an OUD-specific PDT had a net cost reduction for inpatient and outpatient services of $2708 per patient over 9 months compared to patients who did not engage with the PDT, despite similar levels of buprenorphine adherence.
一种处方数字疗法（PDT）（reSET-O）可能会扩大对接受丁丙诺啡治疗的阿片类物质使用障碍（OUD）患者的行为治疗的可及性，但缺乏关于其有效性的长期数据。
比较使用reSET-O和丁丙诺啡的患者与仅接受丁丙诺啡治疗且在第一周后未填写reSET-O处方或未参与该数字疗法的类似康复患者之间的实际医疗资源利用（HCRU）情况。
对开始使用PDT且在开始后连续加入健康计划12周及9个月的成年人的机构和临床服务索赔数据进行回顾性分析。将填写了处方并参与该疗法的患者与填写了处方但在第一周后未参与的患者（NE）以及未填写处方的患者（NR）（后两组合并为一组，以下称为“未参与者”）进行比较。使用重复测量负二项式模型分析各阶段的就诊次数/程序，并根据每个阶段的天数进行调整。使用当前医疗保险报销率评估相关成本趋势。
共有444名患者兑换了处方并参与了该数字疗法（平均年龄37.5岁，63.1%为女性，84%为医疗补助计划参保者），64名患者未参与该数字疗法（平均年龄39.5岁，32.8%为女性，73.4%为医疗补助计划参保者）。参与治疗的患者的医院机构就诊总费用为2693美元，未参与治疗的患者为6130美元。参与治疗的患者某些临床医生服务的使用率略高。参与治疗与未参与治疗的患者的机构和临床医生服务总费用分别为8733美元和11441美元，与未参与reSET-O治疗的患者相比，参与治疗的患者在9个月内每人净节省成本2708美元。
与未参与数字疗法的患者相比，参与针对OUD的数字疗法的患者在9个月内的住院和门诊服务净成本每人降低了2708美元，尽管他们的丁丙诺啡依从性水平相似。
