자료유형  

 학위논문

Control Number  

0016933756

International Standard Book Number  

9798380263689

Dewey Decimal Classification Number  

150

Main Entry-Personal Name  

Adams, Jeremy Tyler.

Publication, Distribution, etc. (Imprint  

[S.l.] : University of Pittsburgh., 2021

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2021

Physical Description  

1 online resource(140 p.)

General Note  

Source: Dissertations Abstracts International, Volume: 85-03, Section: B.

General Note  

Advisor: Smith, Kenneth J.;Childers, Julie W.;Bryce, Cindy L.;Donohue, Julie M.

Dissertation Note  

Thesis (Ph.D.)--University of Pittsburgh, 2021.

Restrictions on Access Note  

This item must not be sold to any third party vendors.

Summary, Etc.  

요약Extended-release medications for opioid use disorder (ERMOUD) are newer additions to combat the opioid epidemic. While more expensive than daily-administered formulations, they offer unique advantages. These include lessening the burden and constraints of daily adherence, improving treatment retention, and potentially improving long term remission, along with eliminating the risk of drug diversion and fatal accidental poisoning in children.Opioid use disorder (OUD) is now viewed as a chronic medical condition, requiring longterm treatment, expectant of relapses and illicit reuse, and multiple treatment strategies and trials. Therefore, it is important to evaluate the cost-effectiveness of these newer extended-release medications, along with the daily-administered formulations, in the context of this newly adopted disease paradigm.In Chapter One, we performed a cost-effectiveness analysis of ERMOUDs in both singledrug and multi-drug-in-sequence treatment strategies, allowing for readmission and transition to another drug regimen upon discontinuation or attrition due to illicit opioid use. Prior economic models did not allow treatment reentry nor switching. We found that ERMOUD multi-drug-insequence combination treatment strategies prove more cost-effective than single-drug ERMOUD treatment strategies and are a cost-effective alternative to daily administration MOUD regimens.We triplicated our model in Chapter Twoto compare three different drug pricing schedules: Wholesale Acquisition Costs (WAC), Drug Manufacturer's Net Price (DMN), and Medicaid Rebate-Adjusted Prices (MRA). We found that using MRA prices, which represents the majority of OUD patients, increases the viability and cost-effective competitiveness of ERMOUDs, while closer approximating real-world pricing conditions.We further expanded our model in Chapter Threeto include the original mainstays of MOUD, Methadone and Buprenorphine Maintenance Treatments, both singly and in multi-drugin-sequence combinations. Thus, we were able to conduct a comprehensive cost-effectiveness analysis on essentially all available MOUD treatment strategies, allowing for readmission and drug switching. We found that, while the newer ERMOUDs are an important addition to the treatment options of OUD, and provide unique clinical advantages over the daily formulations, the singledrug BMT-only treatment strategy tested as the most cost-effective, at least until the price of both extended-release and daily formulations better align with their demonstrated benefits.

Subject Added Entry-Topical Term  

Abstinence.

Subject Added Entry-Topical Term  

Sensitivity analysis.

Subject Added Entry-Topical Term  

Success.

Subject Added Entry-Topical Term  

Health care policy.

Subject Added Entry-Topical Term  

Mortality.

Subject Added Entry-Topical Term  

Methadone.

Subject Added Entry-Topical Term  

Pandemics.

Subject Added Entry-Topical Term  

Chronic illnesses.

Subject Added Entry-Topical Term  

Clinical trials.

Subject Added Entry-Topical Term  

Urine.

Subject Added Entry-Topical Term  

Remission (Medicine).

Subject Added Entry-Topical Term  

Health care expenditures.

Subject Added Entry-Topical Term  

Prescription drugs.

Subject Added Entry-Topical Term  

Substance use disorder.

Subject Added Entry-Topical Term  

Drug dosages.

Subject Added Entry-Topical Term  

Narcotics.

Subject Added Entry-Topical Term  

COVID-19.

Subject Added Entry-Topical Term  

Epidemiology.

Subject Added Entry-Topical Term  

Health care management.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Pharmaceutical sciences.

Added Entry-Corporate Name  

University of Pittsburgh.

Host Item Entry  

Dissertations Abstracts International. 85-03B.

Host Item Entry  

Dissertation Abstract International

Electronic Location and Access  

로그인을 한후 보실 수 있는 자료입니다.

Control Number  

joongbu:641297