Quality of Life Outcomes in Prescription and Injection Opioid Dependence
The study will measure quality of life in opioid dependence using primary data from a survey of the US population and secondary data from opioid dependent patients enrolled in three national studies. The results will provide quality of life estimates and guidance for cost-effectiveness and comparative effectiveness studies of opioid dependence treatment, and evaluate novel methodologies for assessing these outcomes.
Opioid dependence treatment is primarily evaluated based on measures of abstinence or reduction in opioid consumption. Related economic research has frequently used a cost-benefit approach that emphasizes economic offsets to treatment costs that occur outside of health care, such as reduced costs to the legal system. The proposed research recognizes that the value delivered by opioid dependence treatment should be appropriate to the additional cost to the health system, but that requiring cost savings applies a higher economic standard to this treatment than to other medical interventions. This study proposes that an equal bar is the most effective way to ensure quality outcomes for substance use. To capture the social welfare effects of opioid dependence that have hitherto been included in cost-benefit analytic approaches, this study will take a broader view of quality of life attributes than is traditionally included in cost-effectiveness analysis, and evaluate the benefits of integrating these attributes into quality of life outcome measures that are used to evaluate other medical treatments and interventions.
This study will expand scientific knowledge and technical capability by measuring family spillover effects of opioid dependence health states to explore a family-based utility function, and by exploring the validity of different approaches to including co-occurring conditions in quality of life measures. The results of the proposed research will enable opioid dependence treatments to be accurately evaluated using cost-effectiveness techniques that have become widely accepted in medical care in the US and throughout the world. These analyses will enable the identification of the most effective treatments and interventions, and those with greatest value. The results will increase the comparability of opioid dependence treatments and interventions with other medical and health interventions to allow for the consideration of opioid treatments within the medical framework for resource allocation.