Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 22:S1098-3015(25)02473-8.
doi: 10.1016/j.jval.2025.07.008. Online ahead of print.

Cost per Opioid-Free Year: A Systematic Review and Summary Analysis

Babasoji E Oyemakinde  1 , Danielle Ryan  2 , Techna Cadet  3 , Tyler Judge  4 , Manesh Gopaldas  5 , Ali Jalali  2 , Sean M Murphy  2
Affiliations

Cost per Opioid-Free Year: A Systematic Review and Summary Analysis

Babasoji E Oyemakinde et al. Value Health. .

Abstract

Objectives: Opioids remain a leading cause of death in the United States, and time free from opioid use is a common measure of effectiveness in economic evaluations of opioid use disorder (OUD) interventions. This study reviews the economic evaluation literature on OUD, identifies studies that calculated incremental cost-effectiveness ratios (ICER) based on time free from opioids, and establishes a benchmark for comparison in future research.

Methods: The review examined economic evaluations of OUD interventions published in the peer-reviewed literature from inception to September 2024. ICERs of cost per period of opioid-free time were extracted or calculated from studies meeting the inclusion criteria. Monetary values were converted to 2024 USD and ICERs normalized to cost per opioid-free year (OfY). Articles were classified by intervention location (United States vs international) and economic perspective.

Results: Fourteen articles met the inclusion criteria: 8 from the United States, 4 from Australia, 1 from Malaysia, and 1 from the United Kingdom. Among the US-based studies, the average ICER per OfY for the healthcare-sector, the state policymaker, and the societal perspective were $243 053/OfY, $17 674/OfY, and $32 125/OfY, respectively. For international studies, average ICERs for the healthcare-sector and societal perspectives were $79 765/OfY and $195 980/OfY, respectively.

Conclusions: Cost per OfY is a widely used metric in economic evaluations because of its relative importance as a measure of clinical effectiveness. However, a universally accepted benchmark for decision making does not yet exist. This review aggregates data from existing studies that provided this measure, offering an initial step for establishing a cost-effectiveness threshold for cost per OfY.

Keywords: cost per opioid-free year; cost-effectiveness analysis; economic evaluation; opioid use disorder.

PubMed Disclaimer

Conflict of interest statement

Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section.

Similar articles

See all similar articles

References

    1. Centers for Disease Control and Prevention. U.S. Overdose Deaths Decrease in 2023, First Time Since 2018. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm Accessed 10/28/2024.
    1. Murphy SM. The Cost of Opioid Use Disorder and the Value of Aversion. Drug and Alcohol Dependence. 2020:108382. - PMC - PubMed
    1. Grella CE, Ostile E, Scott CK, Dennis M, Carnavale J. A scoping review of barriers and facilitators to implementation of medications for treatment of opioid use disorder within the criminal justice system. International Journal of Drug Policy. 2020; 81:102768. - PMC - PubMed
    1. Cernasev A, Hohmeier KC, Frederick K, Jasmin H, Gatwood J. A systematic literature review of patient perspectives of barriers and facilitators to access, adherence, stigma, and persistence to treatment for substance use disorder. Exploratory research in clinical and social pharmacy. 2021;2:100029. - PMC - PubMed
    1. Jalali A Informing evidence-based medicine for opioid use disorder using pharmacoeconomic studies. Expert Review of Pharmacoeconomics & Outcomes Research 2024; 24(5), 599–611. - PMC - PubMed

LinkOut - more resources