Cost analysis of clinic and office-based treatment of opioid dependence: results with methadone and buprenorphine in clinically stable patients

Drug Alcohol Depend. 2009 Jan 1;99(1-3):132-40. doi: 10.1016/j.drugalcdep.2008.07.013. Epub 2008 Sep 19.


The cost of providing and receiving treatment for opioid dependence can determine its adoption. To compare the cost of clinic-based methadone (MC, n=23), office-based methadone (MO, n=21), and office-based buprenorphine (BO, n=34) we performed an analysis of treatment and patient costs over 6 months of maintenance in patients who had previously been stabilized for at least 1 year. We performed statistical comparisons using ANOVA and chi-square tests and performed a sensitivity analysis varying cost estimates and intensity of clinical contact. The cost of providing 1 month of treatment per patient was $147 (MC), $220 (MO) and $336 (BO) (p<0.001). Mean monthly medication cost was $93 (MC), $86 (MO) and $257 (BO) (p<0.001). The cost to patients was $92 (MC), $63 (MO) and $38 (BO) (p=0.102). Sensitivity analyses, varying cost estimates and clinical contact, result in total monthly costs of $117 to $183 (MC), $149 to $279 (MO), $292 to $499 (BO). Monthly patient costs were $84 to $133 (MC), $55 to $105 (MO) and $34 to $65 (BO). We conclude that providing clinic-based methadone is least expensive. The price of buprenorphine accounts for a major portion of the difference in costs. For patients, office-based treatment may be less expensive.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Buprenorphine / therapeutic use*
  • Cohort Studies
  • Cost of Illness
  • Costs and Cost Analysis
  • Data Interpretation, Statistical
  • Female
  • Health Personnel / economics
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • Narcotics / therapeutic use*
  • Opioid-Related Disorders / economics*
  • Opioid-Related Disorders / rehabilitation*
  • Physicians' Offices / economics
  • Socioeconomic Factors
  • Substance Abuse Detection
  • Substance Abuse Treatment Centers / economics
  • Treatment Outcome
  • Young Adult


  • Narcotics
  • Buprenorphine
  • Methadone