Settumba Stella, Shahbazi Jeyran, Byrne Marianne, Degenhardt Louisa, Grebely Jason, Larance Briony, Nielsen Suzanne, Lintzeris Nicholas, Ali Robert, Rodgers Craig, Blazey Alison, Weiss Robert, Dunlop Adrian, McDonough Michael, Cook Jon, Farrell Michael
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
The Kirby Institute, UNSW Sydney, Sydney, Australia.
Drug Alcohol Rev. 2025 Jan;44(1):179-194. doi: 10.1111/dar.13956. Epub 2024 Oct 6.
The costs of providing medication-assisted treatment for opioid dependence can determine its scale of provision. To provide estimates of the costs of extended-release buprenorphine (BUP-XR), we performed a bottom-up costing analysis of provider operational treatment costs.
Data were collected in a single-arm open label trial of BUP-XR injections conducted in specialist public drug treatment services and primary care private practices in three Australian states (the CoLAB study). The unit costs of resources used for each activity were combined with quantities used at each participating facility to arrive at the average annual cost per client.
One hundred participants across the six health facility sites received monthly subcutaneous BUP-XR injections administered by a health-care practitioner. The average cost of providing 1 year of treatment per participant was $6656 ($6026-$8326). Screening cost (initial assessment and medical history) was $282 while monthly follow-up appointments cost $531 per client. The main cost driver was the monthly treatment costs accounting for 79% of the average annual client cost, with medication costs comprising 95% of this cost.
With medication costs making up the largest proportion of treatment costs, treatment using BUP-XR has the potential to free up other health system resources, for example, staff time. The costs reported in this study can be used in an economic evaluation to estimate the net benefit or cost-effectiveness of BUP-XR especially when compared to other opioid agonist treatments.
提供阿片类药物依赖药物辅助治疗的成本会决定其提供规模。为了估算缓释丁丙诺啡（BUP-XR）的成本，我们对提供者的运营治疗成本进行了自下而上的成本分析。
数据收集于一项在澳大利亚三个州的专科公共药物治疗服务机构和初级保健私人诊所进行的BUP-XR注射单臂开放标签试验（CoLAB研究）。将每项活动所用资源的单位成本与每个参与机构的使用量相结合，得出每位患者的平均年度成本。
六个医疗机构站点的100名参与者接受了由医护人员每月进行的皮下BUP-XR注射。每位参与者提供1年治疗的平均成本为6656美元（6026 - 8326美元）。筛查成本（初始评估和病史）为282美元，而每位患者每月的随访预约成本为531美元。主要成本驱动因素是每月的治疗成本，占平均年度患者成本的79%，其中药物成本占该成本的95%。
由于药物成本占治疗成本的比例最大，使用BUP-XR进行治疗有可能释放其他卫生系统资源，例如工作人员时间。本研究报告的成本可用于经济评估，以估算BUP-XR的净效益或成本效益，特别是与其他阿片类激动剂治疗相比时。
