Pear Therapeutics (US), Inc., 200 State St., Boston, MA, 02109, USA.
Market Access Consulting, Labcorp Drug Development, Gaithersburg, MD, USA.
Adv Ther. 2022 Sep;39(9):4131-4145. doi: 10.1007/s12325-022-02217-y. Epub 2022 Jul 7.
reSET-O, an FDA-authorized prescription digital therapeutic (PDT) delivering cognitive behavioral therapy and contingency management to patients with opioid use disorder (OUD), may help improve clinical outcomes. One-year differences in healthcare resource utilization (HCRU) and costs post-PDT initiation were evaluated.
Retrospective analysis of healthcare claims data compared all-cause HCRU (across hospital facility encounters [sum of inpatient stays, treat-and-release emergency department [ED] visits, partial hospitalizations, and hospital outpatient department visits] and clinician services [procedure categories]) after PDT initiation (index) between reSET-O patients and controls. Overall and Medicaid-specific differences in HCRU, costs, and buprenorphine adherence were evaluated.
Cohorts included 901 reSET-O patients (median age 36 years, 62.4% female, 73.9% Medicaid) and 978 controls (median age 38 years, 51.1% female, 65.4% Medicaid). Compared to the control group, the reSET-O group experienced 12% fewer total unique hospital encounters (non-significant), driven by 28% fewer inpatient stays (IRR 0.72; 95% CI 0.55-0.96; P = 0.02), 56% fewer hospital readmissions [IRR 0.44; 95% CI 0.20-0.93; P = 0.033]), and 7% fewer ED visits (IRR 0.93; 95% CI 0.79-1.09; P = 0.386). Total clinician services increased by 1391 events versus controls. Differences were greater among the Medicaid patients. Adjustment for concomitant baseline substance use and mental health disorders resulted in similar HCRU incidence rate ratios. Changes in all-cause HCRU drove per-patient per-year cost differences of - $2791 versus controls (- $3832 versus Medicaid controls). Adjusted mean medication possession ratio was 0.848 (SE 0.0118) at 12 months for reSET-O patients, which was significantly higher than controls (0.761 [SE 0.0108]; P < 0.001).
Use of reSET-O is associated with significant and durable real-world reductions in ED and inpatient (including readmissions) utilization, reduced net costs, and increased clinician services and buprenorphine adherence. Differences in costs versus controls were greatest among Medicaid patients. INFOGRAPHIC.
reSET-O 是一款获得 FDA 批准的处方数字疗法 (PDT)，为阿片类药物使用障碍 (OUD) 患者提供认知行为疗法和应急管理，可能有助于改善临床结果。评估了 PDT 启动后（索引期），患者的医疗资源利用（HCRU）和成本在一年内的差异。
回顾性分析医疗保健索赔数据，比较 reSET-O 患者和对照组在 PDT 启动后（索引期）所有原因 HCRU（跨越医院设施就诊[住院、治疗后释放急诊就诊、部分住院和医院门诊就诊的总和]和临床医生服务[程序类别]）的总 HCRU。评估了 HCRU、成本和丁丙诺啡依从性的总体差异和 Medicaid 特定差异。
队列包括 901 名 reSET-O 患者（中位数年龄 36 岁，62.4%为女性，73.9%为 Medicaid）和 978 名对照（中位数年龄 38 岁，51.1%为女性，65.4%为 Medicaid）。与对照组相比，reSET-O 组的总独特住院就诊次数减少了 12%（无统计学意义），这主要是由于住院治疗减少了 28%（IRR 0.72；95%CI 0.55-0.96；P=0.02），住院再入院减少了 56%（IRR 0.44；95%CI 0.20-0.93；P=0.033）），急诊就诊减少了 7%（IRR 0.93；95%CI 0.79-1.09；P=0.386）。与对照组相比，临床医生服务总次数增加了 1391 次。在 Medicaid 患者中差异更大。同时调整基线物质使用和精神健康障碍的情况，结果显示 HCRU 的发生率比相似。所有原因 HCRU 的变化导致患者每年每人的成本差异为 -2791 美元，而对照组为 -3832 美元（与 Medicaid 对照组相比为 -3832 美元）。12 个月时，reSET-O 患者的平均药物占有率为 0.848（SE 0.0118），显著高于对照组（0.761 [SE 0.0108]；P<0.001）。
reSET-O 的使用与 ED 和住院（包括再入院）利用率的显著和持久的实际减少、净成本降低以及临床医生服务和丁丙诺啡依从性的增加有关。与对照组相比，成本差异在 Medicaid 患者中最大。信息图。
