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Heroin Addiction and Related Clinical Problems: 2014, 16, 4 (pages: 57 - 62)

Evaluation and cost analysis in two groups of patients who had been randomized for toxicological monitoring

Stella L., Guida F., Nava E., Romano A., Pisanti F., Aprea E., Scala G., Crinisio A., Alfieri A., Coppola O., Leone A., and de Novellis V.

Summary: Aim: identify factors which may be responsible for variations in methadone-related deaths in Scotland. Method: computer modelling based on data from drug-related deaths in Scotland in 2012 was used to predict the most effective combination of clinical parameters (methadone dose; supervision rates and provision of buprenorphine) that may predict how to reduce methadone-related deaths. Results: doubling the proportion of patients receiving buprenorphine (from 12% to 24%) would reduce the overall death rate by 18% (from 7.58 to 6.20 deaths per thousand problem drug users ~ 82 deaths). This would cost an additional £2.52 million (£31 000 per life saved). Increasing the supervision rate for methadone from 57% to 67% would reduce the overall death rate by 0.68% (3 deaths ~ £423 000 per life saved) while increasing the average daily dose of methadone from 90 mg to 100 mg would reduce the overall death rate by 2.5% (11 deaths ~ £48 000 per life saved). Conclusion: greater use of buprenorphine products could significantly reduce methadone-related deaths.