Opioid Medication Costs Spiral, But Proof of Efficacy Is Lacking

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The Cleveland Plain Dealer says judges, doctors and lawmakers on the front lines of the opioid addiction crisis have a problem: Three medications are available to help the estimated 200,000 Ohioans struggling to recover from addiction, and yet there are no clear answers as to which, if any, drug works best. The skyrocketing demand for treatment has spurred competition among drugmakers for a piece of the growing market, which in Ohio is worth well over $100 million a year in public money alone. It has led to a vigorous debate about how to spend limited tax money while also saving the most lives.

The fastest-growing medication has the shortest track record and the highest price: Vivitrol, a monthly shot that blocks receptors in the brain so that a person can’t feel the euphoria from opioids. In 2012, Ohio Medicaid paid for 100 doses of the injectable medication. Last year, it paid for over 30,000 doses — at a cost of more than $38 million. Vivitrol is now a go-to option in many of Ohio’s 95 drug courts, which have become a de facto gateway to treatment for those arrested for possessing drugs or committing crimes to support an addiction. It also has strong backing among state lawmakers. Research is lacking on efficacy, but lawmakers say they can’t wait to act. “We’re going to fire all the bullets in the gun at the problem,” Rep. Robert Sprague said. “We don’t have time for a four-year double-blind study to see what works best.”

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