In the US, emergency department (ED)-initiated buprenorphine intervention for patients with opioid dependence provides high value compared with referral to community-based treatment or combined brief intervention and referral, a recent study found. Researchers evaluated patients with opioid dependency (aged ≥18 years) in an urban ED. Self-reported 30-day assessment data were used to construct cost-effectiveness acceptability curves for patient engagement in formal addiction treatment at 30 days and the number of days that were free of illicit opioids in the past week. They found:

• Considering only health-care system costs, cost-effectiveness acceptability curves indicate that at all positive willingness-to-pay values, ED-initiated buprenorphine treatment was more cost-effective than brief intervention or referral.
• For example, at a willingness-to-pay threshold of $1,000 for 30-day treatment engagement, there was a 79% certainty that ED-initiated buprenorphine is most cost-effective compared with other studied treatments.
• Similar results were found for days that were free of illicit opioids in the past week.