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Research Summary

Methadone Treatment Reduces Overall Health-Care Costs for Commercially Insured Patients with Opioid Dependence

Under the Mental Health Parity and Addiction Equity Act, insurers are now required to cover addiction treatment. To assess the costs associated with treating opioid dependence, researchers reviewed data from a not-for-profit health maintenance organization that covered addiction services, including methadone. Patients with at least 2 opioid-dependence diagnoses between 2000 and 2004 (N=1518) were assigned to 1 of 3 addiction treatment categories: no treatment, outpatient treatment without methadone, and methadone treatment. Researchers then compared differences in health-care utilization and costs between groups, controlling for age, gender, and Medicaid status.

  • Fifty-one percent of opioid-dependent patients received methadone, 34% received outpatient treatment, and 15% did not receive treatment.
  • Eighty-six percent of patients made at least 1 primary-care visit. Forty-eight percent visited the emergency department (ED), and 24% were hospitalized.
  • Compared with the outpatient and no-treatment groups, methadone recipients had significantly fewer annual ED visits (1.3 versus 2.6 and 3.7, respectively), primary-care visits (3.8 versus 7.5 and 9.0, respectively), and hospitalizations (0.2 versus 0.6 and 1.1, respectively).
  • Mean yearly health-care costs were lower for the methadone group compared with the outpatient and no-treatment groups ($7,163 versus $14,157 and $18,695, respectively).

Comments:

Although this observational study could not fully account for confounders that influence patterns of health-care utilization, the finding that opioid-dependent patients who participate in methadone treatment are less expensive to insurers than patients who go without it may allay cost concerns as addiction treatment is incorporated into covered services. Hillary Kunins, MD, MPH, MS

Reference:

McCarty D, Perrin NA, Green CA, et al. Methadone maintenance and the cost and utilization of health care among individuals dependent on opioids in a commercial health plan. Drug Alcohol Depend. June 3, 2010 [E-pub ahead of print].

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