Thanh Lu, Danielle Ryan, Techna Cadet, Marek C Chawarski, Edouard Coupet, E Jennifer Edelman, Kathryn F Hawk, Kristen Huntley, Ali Jalali, Patrick G O'Connor, Patricia H Owens, Shara H Martel, David A Fiellin, Gail D'Onofrio, Sean M Murphy
{"title":"Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder.","authors":"Thanh Lu, Danielle Ryan, Techna Cadet, Marek C Chawarski, Edouard Coupet, E Jennifer Edelman, Kathryn F Hawk, Kristen Huntley, Ali Jalali, Patrick G O'Connor, Patricia H Owens, Shara H Martel, David A Fiellin, Gail D'Onofrio, Sean M Murphy","doi":"10.1016/j.annemergmed.2024.10.001","DOIUrl":"10.1016/j.annemergmed.2024.10.001","url":null,"abstract":"<p><strong>Study objective(s): </strong>To evaluate the cost-effectiveness of implementation facilitation compared with a standard educational strategy to promote emergency department (ED)-initiated buprenorphine with linkage to ongoing opioid use disorder care in the community, from a health care-sector perspective.</p><p><strong>Methods: </strong>A prospective cost-effectiveness analysis was conducted alongside \"Project ED Health\" (CTN-0069), a hybrid type 3 implementation-effectiveness study conducted at 4 academic EDs. Resources were gathered and valued according to the health care-sector perspective. Three effectiveness measures were evaluated: quality-adjusted life-years, opioid-free years, and patient engagement in community-based opioid use disorder care on the 30th day following the index ED visit. An incremental cost-effectiveness ratio was calculated for each measure of effectiveness. Likelihood of cost-effectiveness was evaluated across a wide range of \"value\" thresholds through cost-effectiveness acceptability curves.</p><p><strong>Results: </strong>The mean, per-person, health care-sector cost associated with ED-administered buprenorphine following implementation facilitation did not differ significantly from that of standard education ($3,239 versus $4,904), whereas the mean effectiveness for all 3 measures significantly favored the implementation facilitation strategy. Implementation facilitation has a 74% to 75% probability of being considered cost-effective from a health care-sector perspective at the recommended value range of $100,000 to $200,000 per quality-adjusted life-year. Incremental cost-effectiveness ratios estimated using secondary effectiveness measures had a 75% probability of being considered cost-effective at $25,000 per opioid-free year and $38,000 per engagement.</p><p><strong>Conclusion: </strong>Implementation facilitation, relative to a standard educational strategy, has a moderate-to-high likelihood of being considered cost-effective from a health care-sector perspective, depending on decisionmakers' willingness to pay for units of effectiveness.</p>","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine","authors":"Theresa M. van der Vlugt MD","doi":"10.1016/j.annemergmed.2024.07.016","DOIUrl":"10.1016/j.annemergmed.2024.07.016","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"84 6","pages":"Pages 700-703"},"PeriodicalIF":5.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Information for Readers","authors":"","doi":"10.1016/S0196-0644(24)01175-2","DOIUrl":"10.1016/S0196-0644(24)01175-2","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"84 6","pages":"Page A11"},"PeriodicalIF":5.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Global Research Highlights","authors":"","doi":"10.1016/j.annemergmed.2024.10.005","DOIUrl":"10.1016/j.annemergmed.2024.10.005","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"84 6","pages":"Pages A8-A10"},"PeriodicalIF":5.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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