Extended-release naltrexone for alcohol dependence

persistence and healthcare costs and utilization.

William C. Bryson, Kenneth (John) McConnell, Todd Krothuis, Dennis McCarty

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Evaluate persistence with treatment, healthcare costs, and utilization in stably enrolled Aetna Behavioral Health members receiving extended-release naltrexone (XR-NTX) for alcohol use dependence compared with oral medications and psychosocial therapy only. Historical cohort study. Aetna beneficiaries with stable enrollment (at least 6 months before and after index treatment) who initiated pharmacotherapy with XR-NTX (n = 211), disulfiram (n = 1043), oral naltrexone (n = 1408), acamprosate (n = 2479), or psychosocial therapy only (n = 6374) for alcohol use disorders between January 1, 2007, and December 31, 2008, were extracted and deidentified from Aetna's nationwide claims and utilization database. Survival analysis compared persistence with XR-NTX versus oral pharmacotherapies. Difference-in-differences analysis compared healthcare costs and utilization among patients receiving XR-NTX versus oral pharmacotherapies and psychosocial therapy only. Multivariate analyses controlled for demographics. Patients taking acamprosate and disulfiram were more likely to discontinue treatment than patients taking naltrexone, and patients given oral naltrexone were more likely to discontinue treatment than those given XR-NTX. Outpatient behavioral health treatment visits increased in all study groups. Nonpharmacy healthcare costs and utilization of inpatient and emergency services decreased in the XR-NTX group relative to other study groups. Patients receiving XR-NTX persisted with treatment longer than patients receiving oral alcohol use-disorder medications or psychosocial therapy only, and had decreased inpatient and emergency healthcare costs and utilization compared with those receiving other medications.

Original languageEnglish (US)
JournalThe American journal of managed care
Volume17 Suppl 8
StatePublished - Jun 2011
Externally publishedYes

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Naltrexone
Health Care Costs
Alcoholism
Disulfiram
Therapeutics
Drug Therapy
Inpatients
Emergencies
Alcohols
Health
Survival Analysis
Cohort Studies
Outpatients
Multivariate Analysis
Demography
Databases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Extended-release naltrexone for alcohol dependence : persistence and healthcare costs and utilization. / Bryson, William C.; McConnell, Kenneth (John); Krothuis, Todd; McCarty, Dennis.

In: The American journal of managed care, Vol. 17 Suppl 8, 06.2011.

Research output: Contribution to journalArticle

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