Trial reportAddiction (Abingdon, England)2017
Cost-effectiveness of extended release naltrexone to prevent relapse among criminal justice-involved individuals with a history of opioid use disorder.
Trial report in Addiction (Abingdon, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Cost per Opioid-Free Year: A Systematic Review and Summary Analysis.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2025Pooled it
- Economic Evaluations of Pharmacologic Treatment for Opioid Use Disorder: A Systematic Literature Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2021Pooled it
- Interventions for female drug-using offenders.The Cochrane database of systematic reviews · 2019Pooled it
- A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature.Journal of addictions nursingPooled it
- Cost-Effectiveness of Linkage Case Management for Hospitalized People With HIV.JAMA network open · 2025Trial
- Health care use and cost of treatment for adolescents and young adults with opioid use disorder.Journal of substance use and addiction treatment · 2023Trial
- Determinants of health-related quality of life among individuals with opioid use disorder, recently released from incarceration.Addiction science & clinical practice · 2023Trial
- Cost-effectiveness of extended-release injectable naltrexone among incarcerated persons with opioid use disorder before release from prison versus after release.Journal of substance abuse treatment · 2022Trial
- Cost-Effectiveness of Buprenorphine-Naloxone Versus Extended-Release Naltrexone to Prevent Opioid Relapse.Annals of internal medicine · 2019Trial
- Rationale, design, and methodology of a randomized controlled trial evaluating the impact of peer-enhanced care coordination on linkage to HCV care among formerly incarcerated individuals.Contemporary clinical trials · 2025Article
- Cost-Effectiveness of Implementation Facilitation to Promote Emergency Department-Initiated Buprenorphine for Opioid Use Disorder.Annals of emergency medicine · 2025Article
- Comparative- and Cost-Effectiveness Research Determining the Optimal Intervention for Advancing Transgender Women With HIV to Full Viral Suppression (Text Me, Alexis!): Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- Community-involved economic evaluation and development of a cost-effectiveness calculator for two peer-driven substance use interventions.Frontiers in public health · 2025Article
- Article
- Community-based substance use treatment programs for reentering justice-involved adults: A scoping review.Drug and alcohol dependence reports · 2024Article
- Escalating costs of self-injury mortality in the 21st century United States: an interstate observational study.BMC public health · 2023Observational
- Patient motivators to use opioids for acute pain after emergency care.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- Econometric Issues in Prospective Economic Evaluations Alongside Clinical Trials: Combining the Nonparametric Bootstrap With Methods That Address Missing Data.Epidemiologic reviews · 2022Review
- Patient Pain Experiences and the Emergency Department Encounter: A Qualitative Analysis.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2022Article
- Onsite buprenorphine inductions at harm reduction agencies to increase treatment engagement and reduce HIV risk: Design and rationale.Contemporary clinical trials · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
BACKGROUND AND
aimsCriminal justice-involved individuals are highly susceptible to opioid relapse and overdose-related deaths. In a recent randomized trial, we demonstrated the effectiveness of extended-release naltrexone (XR-NTX; Vivitrol
designEconomic evaluation of the aforementioned trial from the taxpayer perspective. Participants were randomized to 25 weeks of XR-NTX injections or TAU; follow-up occurred at 52 and 78 weeks.
settingFive study sites in the US Northeast corridor.
participantsA total of 308 participants were randomized to XR-NTX (n = 153) or TAU (n = 155). MEASUREMENTS: Incremental costs relative to incremental economic and clinical effectiveness measures, QALYs and abstinent years, respectively.
findingsThe 25-week cost per QALY and abstinent-year figures were $162 150 and $46 329, respectively. The 78-week figures were $76 400/QALY and $16 371/abstinent year. At 25 weeks, we can be 10% certain that XR-NTX is cost-effective at a value threshold of $100 000/QALY and 62% certain at $200 000/QALY. At 78 weeks, the cost-effectiveness probabilities are 59% at $100 000/QALY and 76% at $200 000/QALY. We can be 95% confident that the intervention would be considered 'good value' at $90 000/abstinent year at 25 weeks and $500/abstinent year at 78 weeks.
conclusionsWhile extended-release naltrexone appears to be effective in increasing both quality-adjusted life-years (QALYs) and abstinence, it does not appear to be cost-effective using generally accepted value thresholds for QALYs, due to the high price of the injection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.