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

J Subst Abuse Treat. 2014 Aug;47(2):113-21. doi: 10.1016/j.jsat.2014.03.007. Epub 2014 Apr 13.

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.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Alcoholism / drug therapy*
  • Delayed-Action Preparations
  • Health Care Costs
  • Humans
  • Medication Adherence
  • Naltrexone / administration & dosage
  • Naltrexone / economics
  • Naltrexone / therapeutic use*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / economics
  • Narcotic Antagonists / therapeutic use
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / economics

Substances

  • Delayed-Action Preparations
  • Narcotic Antagonists
  • Naltrexone