Buprenorphine tablets are more expensive than the methadone used in maintenance programs, which has led insurers to restrict access. But early studies have demonstrated that buprenorphine treatment may be a cost effective treatment option.
Suboxone® and Subutex® are expensive. The below-wholesale discounted cost of an 8 mg Suboxone® tablet is just under $5, leading to a medication cost of about $140-$420 per month. The sublingual formulations will go off patent in 2009, but currently there is no generic or other lower cost alternative.
Hypothetical models in the United States and cost-effectiveness analyses based on clinical trials in other countries indicate that, despite its higher costs, buprenorphine and methadone are similarly cost-effective. Taking the more favorable clinical trial evidence for methadones effectiveness into account, these studies still suggest lower overall health care costs for buprenorphine. Better information is needed to accurately assess the comparative efficiency of these treatments in real-world and in U.S.-based settings (Barnett, Zaric, et al. 2001; Rosenheck and Kosten 2001;. Other factors that should be considered in cost analyses are that effective substance abuse treatment has been shown to lower criminal justice costs and reduce the spread of infectious disease (Rosenheck and Kosten 2001; Schackman, Merrill, et al. 2006).
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