Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies

Daniel M. Hartung; Dennis McCarty; Rongwei Fu; Katharina Wiest; Mady Chalk; David R. Gastfriend

doi:10.1016/j.jsat.2014.03.007

Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies

Daniel M. Hartung, Dennis McCarty, Rongwei Fu, Katharina Wiest, Mady Chalk, David R. Gastfriend

School Of Public Health

Research output: Contribution to journal › Article › peer-review

46 Scopus citations

Abstract

Through improved adherence, once-monthly injectable extended-release naltrexone (XR-NTX) may provide an advantage over other oral agents approved for alcohol and opioid dependence treatment. The objective of this study was to evaluate cost and utilization outcomes between XR-NTX and other pharmacotherapies for treatment of alcohol and opioid dependence. Published studies were identified through comprehensive search of two electronic databases. Studies were included if they compared XR-NTX to other approved medicines and reported economic and healthcare utilization outcomes in patients with opioid or alcohol dependence. We identified five observational studies comparing 1,565 patients using XR-NTX to other therapies over 6. months. Alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone. Healthcare utilization and costs was generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.

Original language	English (US)
Pages (from-to)	113-121
Number of pages	9
Journal	Journal of Substance Abuse Treatment
Volume	47
Issue number	2
DOIs	https://doi.org/10.1016/j.jsat.2014.03.007
State	Published - Aug 2014

Keywords

Alcohol dependence
Naltrexone
Opioid dependence

ASJC Scopus subject areas

Phychiatric Mental Health
Medicine (miscellaneous)
Clinical Psychology
Psychiatry and Mental health

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10.1016/j.jsat.2014.03.007

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title = "Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies",

abstract = "Through improved adherence, once-monthly injectable extended-release naltrexone (XR-NTX) may provide an advantage over other oral agents approved for alcohol and opioid dependence treatment. The objective of this study was to evaluate cost and utilization outcomes between XR-NTX and other pharmacotherapies for treatment of alcohol and opioid dependence. Published studies were identified through comprehensive search of two electronic databases. Studies were included if they compared XR-NTX to other approved medicines and reported economic and healthcare utilization outcomes in patients with opioid or alcohol dependence. We identified five observational studies comparing 1,565 patients using XR-NTX to other therapies over 6. months. Alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone. Healthcare utilization and costs was generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.",

keywords = "Alcohol dependence, Naltrexone, Opioid dependence",

author = "Hartung, {Daniel M.} and Dennis McCarty and Rongwei Fu and Katharina Wiest and Mady Chalk and Gastfriend, {David R.}",

note = "Funding Information: At the time this work was completed, Daniel Hartung had a career development award (1K12HS019456) provided through the Oregon Comparative Effectiveness Research K12 Program from the Agency for Healthcare Research and Quality. Dennis McCarty also has support from a Research Services Agreement from Purdue Pharma and awards from the National Institute on Drug Abuse (U10 DA015815, P50 DA018165, R01 DA029716, R21 DA035640). Mady Chalk has received travel support and speaker fees from Alkermes, Inc. At the time of the study, David Gastfriend was the Vice President for Scientific Communications at Alkermes, Inc. and participated in the design, conduct, and analysis of this study and in the decision to submit the manuscript for publication. Dr. Gastfriend is now with Treatment Research Institute. Daniel Hartung, Rongwei Fu, and Katharina Wiest have no additional conflicts. ",

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AU - Fu, Rongwei

AU - Wiest, Katharina

AU - Chalk, Mady

AU - Gastfriend, David R.

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Extended-release naltrexone for alcohol and opioid dependence: A meta-analysis of healthcare utilization studies

Abstract

Keywords

ASJC Scopus subject areas

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