– New Report from New England CEPAC Shows Long-term Maintenance Therapy with Medication is an Essential Part of Treatment –
Boston, Mass., July 22, 2014 – The New England Comparative Effectiveness Public Advisory Council (CEPAC), a core program of the Institute for Clinical and Economic Review (ICER), has released a final evidence report on management options for patients with opioid dependence. The final report incorporates findings from a recent public meeting of the New England CEPAC, where council members reviewed evidence on the effectiveness and value of different management approaches for opioid dependence and made recommendations to guide practice and policy. The key findings of the review and votes of CEPAC found that treatment programs that use a medication like methadone to replace the opioid (a method known as maintenance therapy) are more effective than short-term managed withdrawal approaches that attempt to discontinue all opioid use (sometimes referred to as detoxification). Short-term withdrawal management programs typically focus on weaning patients off opioids within a 30-day timeframe, while maintenance programs assume patients will remain on medication for longer periods of time.
CEPAC also voted that maintenance therapy represents a “high value” due to evidence showing that expanding access to maintenance medication saves money, as dependent patients not receiving treatment generate substantial health care costs, engage in higher levels of criminal activity, and have high rates of absenteeism from work or school. The final report concludes that for every additional dollar spent on maintenance treatment in New England, $1.80 in savings would be seen in the health care system.
During the meeting, CEPAC also formed recommendations with a panel of leading regional clinical and policy experts for ways to coordinate efforts in New England to expand access to effective treatment options for opioid dependence, individualize treatment, and build system capacity to support the diverse needs of patients with addiction. The full list of policy recommendations is available in the final report.
The final report, titled “Management Options for Patients with Opioid Dependence,” compares common approaches to opioid dependence treatment. It offers insight into which management options provide the best outcomes for patients and how the options compare from a budget impact and cost-effectiveness perspective. The review focuses on three key pharmacologic interventions: methadone, buprenorphine/Suboxone®, and naltrexone.
Since 1999, fatal drug overdoses have more than doubled in the United States, with pharmaceutical overdoses – particularly from opioid pain medications such as oxycodone, hydrocodone, and methadone – driving the increase. Heroin use is also on the rise, and death from drug overdose is now the leading cause of accidental death in the United States, outpacing deaths from homicide, suicide, and traffic fatalities. In New England and across the country, state leaders have acknowledged the growing opioid epidemic and are searching for strategies to manage dependency while tackling issues related to access, costs, and safety. New England state governors have responded with urgency and are developing a multi-faceted regional approach to combating the problem. The New England CEPAC report will provide guidance to physicians, patients, and policymakers in New England confronted with decisions on how to most effectively manage opioid dependence.
CEPAC is a regional body whose goal is to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across New England. Backed from a consortium of New England state health policy leaders, CEPAC holds public meetings to consider evidence reviews of a range of topics, including clinical interventions and models for care delivery, and provide judgments regarding how the evidence can best be used across New England to improve the quality and value of health care services. ICER manages the day-to-day operations of CEPAC as one of its core programs meant to translate and implement existing evidence reviews to improve their usefulness for patients, clinicians, and payers. For more information about CEPAC, please visit cepac.icer-review.org.
The Institute for Clinical and Economic Review (ICER) is an independent non-profit health care research organization dedicated to improving the interpretation and application of evidence in the health care system. ICER directs two core programs: the California Technology Assessment Forum (CTAF), and the New England Comparative Effectiveness Public Advisory Council (CEPAC). For more information about ICER, please visit ICER’s website, www.icer-review.org.