Combined pharmacotherapy and psychotherapy impact on opioid use disorder treatment.

Abstract

Objective: To examine whether patients with opioid use disorder (OUD) who receive both medications for OUD (MOUD) and psychotherapy experience lower rates of acute care utilization and total cost of care relative to periods when they receive either MOUD or psychotherapy alone.

Study design: Retrospective claims data analysis of commercially insured adults in the US with a diagnosis of OUD between 2019 and 2022.

Methods: Multivariate linear regression models were estimated using rates of all-cause emergency department (ED) visits, inpatient admissions, and total cost of care as the outcome variables. Subsample analyses of urban and rural residents were also performed to examine whether the impacts differ by rurality.

Results: The sample included 18,316 patients representing 450,437 member-month observations. During the months when patients received both MOUD and psychotherapy, their per-member per-month rates of all-cause ED visits and inpatient admissions were lower by 33.5% (P < .001) and 47.6% (P < .001), respectively, relative to months when they received either MOUD or psychotherapy alone. This translated to a 38.3% lower total cost of care (P < .001). Similar magnitudes were noted among both rural and urban residents.

Conclusions: Receipt of both MOUD and psychotherapy is associated with reductions in the rates of ED visits and inpatient admissions along with lower total cost of care relative to receipt of either MOUD or psychotherapy alone. The results suggest that such a combined and complementary approach to OUD treatment may be justified due to its improved patient health outcomes and potential economic value.