December 4, 2017
Community Health Education assistant professor Elizabeth Evans is co-author of a study that appears in the most recent issue of Annals of Internal Medicine. The journal article, titled “Cost-Effectiveness of Publicly Funded Treatment of Opioid Use Disorder in California,” found that if California were to change its policies regarding access to opioid agonist treatments (OAT), the financial and societal benefit to the state could be significant.
The research team based its findings on a cost-effectiveness analysis model that compared California's observed standard of care, in which more than half of patients initiate opioid use disorder treatment with mandated, short-term, medically managed withdrawal, with a hypothetical alternative, in which all patients have immediate access to OAT with methadone of unrestricted duration. The researchers found that treatment with immediate and indefinite OAT for all treatment recipients costs less (by $78,257) than with the observed standard of care. Cost savings were primarily due to lower costs from crime, health resource use, and HIV antiretroviral therapy. Also, patients with immediate and indefinite access to OAT remained in treatment longer, they accumulated more quality adjusted life years (QALYs), and they had lower rates of HIV seroconversion and mortality.
It was estimated that if all Californians starting treatment of opioid use disorder in 2014 had received immediate and indefinite access to OAT, the total lifetime savings to society could be as high as $3.8 billion. The researchers emphasized that the benefits of publicly funded opioid use disorder treatment are maximized when patients receive immediate and unencumbered OAT. Findings can inform efforts to shift public health policy to address the nation’s current opioid epidemic.
Evans, who joined the UMass Amherst faculty this September, is currently the Principal Investigator on a mixed methods study of gender differences in use and outcomes of complementary and integrative healthcare by military veterans with chronic musculoskeletal pain.