Study Finds Extended-Release Naltrexone Can Save Overall Healthcare Costs

An extended-release drug to treat alcohol and opioid dependence can lead to savings in healthcare costs, even though the drug itself is expensive, a new study concludes.

The drug, extended-release Naltrexone, is injected once a month, and costs about $1,100 per injection. The researchers said the drug appears to be significantly more effective than some other medications, because more patients continue using it, compared with cheaper medications that must be taken daily.

The study evaluated five previous trials of the drug, which included 1,565 patients who received extended-release Naltrexone compared to other therapies for six months.

The researchers found patients who used extended-release Naltrexone had generally lower overall costs, compared with patients using other alcohol-dependence treatments. Patients using extended-release Naltrexone were in detoxification and inpatient treatment facilities for fewer days than those who received other treatments, MedicalXpress reports.

Patients using extended-release Naltrexone stuck with their treatment longer than those using the medications acamprosate or oral naltrexone. The study, published in the Journal of Substance Abuse Treatment, was funded by Alkermes, the company that makes Naltrexone.

“Historically, oral medications for substance abuse have not often been prescribed or found to have a high degree of success, mostly because patients stopped taking them,” lead author Dan Hartung of Oregon State University/Oregon Health & Science University College of Pharmacy, said in a news release. “But there are patients who are committed to treating their problems and data showed that they clearly appear to have success with extended-release Naltrexone, which is administered just once a month.”

The Affordable Care Act may allow more patients to have access to medications that treat opioid and alcohol dependence, the article notes.

“There has always been some reluctance on the part of health care practitioners, as well as the patients they are treating, to use prescription medication to treat a substance abuse problem,” Hartung said. “Medication-assisted therapy is underutilized.”

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    May 19, 2014 at 9:44 PM

    My son is a heroin addict. He had been in multiple treatments programs over 2+ years including several intensive inpatient ones. He has currently been sober 8+ months and receiving a monthly Vivitrol injection. I doubt he would have maintained his sobriety without this shot. The injection has given him time to complete an inpatient program, transition to an outpatient program, transition to sober living, and finally transition back into a non-restrictive environment. Having a chance at long-term sobriety has allowed him to start to deal with the emotions and begin the development that he missed during his drug filled adolescence.

    The price of the medication makes it cost prohibitive to many individuals. We had to pay out of pocket for many months. We were fortunate that by changing insurance from my husband’s work to my work policy we now only have to pay the $40 deductible. It is clear that the dollar amount to medical care including overdose, detox, acute inpatient, etc. far exceeded the cost of the injection, even at it’s full $1100 price per month.

    As a parent, I fully support making Vivitrol available on a wide scale basis to anyone who is willing to take this medication. I do not think my son would be where he is in recovery right now without it. I anticipate his continuing on for the medication at least 4 more months before we revisit the situation with his doctor.

    In response to Carlos’ comments, I can say that my son was unable to make an educated decision about his treatment early on because heroin impaired his judgment. In fact, my son only started on the injections because he was given no choice by us or his doctor. He is over 21 but still dependent on us financially. After 8 months on Vivitrol, my son understands the value of the injection. While he does not like having to get the shot, he agrees that it has helped his sobriety because it takes away the temptation. This has allowed him to start to build an opiate free life. I also disagree with Carlos because I saw all treatment as having a cumulative effect on my son. I can’t tell you that the last treatment facility was better than the first one, but something clicked and made my son want to stick with treatment. So, while it was his personal choice to make the decision for treatment, the help of Vivitrol was a vital factor in helping him continue on the recovery road.

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    May 15, 2014 at 5:20 PM

    I worry when the organization that is paying for the study also will benefit economically from the outcome being successful.

    Independent replication of studies are not always available or done. Although it would appear that long extended release medication would have good kinds of outcomes. It has certainly be true for LAAM vs Methadone and Suboxone vs buprenorphine implants placed under the skin Zubsols, Probuphine, epidermic.

    Certainly the study most be done even thought we can extrapolate that it might work. There has been time that just one change can effect the result of outcomes. As we noted when Buprenorphine was introduced as a skin patch transdermal and even the under the skin. Side effects specially and outcomes can change.

    I just hope that patients retain the right of choice of which options they prefer and that professional chose to provide honest and accurate information about each options.

    Too frequently clinicians own bias and preference of treatment or approach is oversold to a patient instead of what is best for the patient. They are really asked specially in substance use treatment, What is it that they want? We have assumed that all patients thinking if faulty and that we most think for them all the time. Or at least on major decisions. Yet I have yet to see any study that make those claims as accurate. We just have accepted many things at face value. Understandingly given that we humans seem to be a machine listening for answers hearing a possibility in the absence of evidence we think better than nothing.

    This is the same conclusion many of us have chosen when we hear “any treatment is better than no treatment”. NOT TRUE.

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