A cost-minimization analysis of telemedicine vs standard induction for buprenorphine: Evidence from a randomized clinical trial in India.
Background: In-person buprenorphine induction poses substantial cost and access barriers in India's opioid agonist treatment programs, while telemedicine-assisted induction may offer a scalable, lower-cost alternative. Aim: To compare the societal costs of telemedicine-assisted buprenorphine inducti...
| Publicado en: | Indian Journal of Psychiatry Vol. 68; no. 7; pp. 609 - 616 |
|---|---|
| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
Jul2026
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195473335&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195473335 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00195545 GDJ jtl: Indian Journal of Psychiatry issn: 00195545 maglogo: N pubinfo: dt: Jul2026 vid: 68 iid: 7 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 195473335 195473335 195473335 10.4103/indianjpsychiatry_116_26 195473335 ppf: 609 ppct: 7 formats: tig: atl: A cost-minimization analysis of telemedicine vs standard induction for buprenorphine: Evidence from a randomized clinical trial in India. aug: au: Singh, Amudeep Dhillon, Harpreet S. Purohit, Neha Ghosh, Abhishek Naik, Shalini Subodh, BN Basu, Debasish Shankar, Prinja affil: Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India sug: subj: Telemedicine Buprenorphine Therapeutic Use Health Care Costs Evaluation Cost Savings Quality of Life Research Subject Retention Outcomes (Health Care) India Human Health Expenditures Descriptive Statistics Comparative Studies Outpatients Tertiary Health Care Questionnaires Stratified Random Sample Summated Rating Scaling Interviews Data Analysis Software Unpaired T-Tests Patient-Reported Outcomes Psychiatric Patients Psychosocial Factors Persons with Substance Use Disorders Psychosocial Factors Substance Use Disorders Drug Therapy Narcotics ab: Background: In-person buprenorphine induction poses substantial cost and access barriers in India's opioid agonist treatment programs, while telemedicine-assisted induction may offer a scalable, lower-cost alternative. Aim: To compare the societal costs of telemedicine-assisted buprenorphine induction (TABI) with standard care (SOC), while evaluating treatment retention and quality-of-life (QoL) outcomes. Methods: An economic evaluation was embedded within a randomized controlled trial at a tertiary addiction treatment center, adopting a societal perspective. Health-system costs were estimated using a mixed top-down/bottom-up micro-costing approach for all participants (n = 138; SOC = 70, TABI = 68), while direct out-of-pocket and indirect wage-loss costs were assessed on day 7 in a predefined sub-sample (n = 57; SOC = 28, TABI = 29). Primary outcomes were 1-week retention and QoL; as effectiveness was comparable between arms, a cost-minimization analysis (CMA) was conducted. Results: Mean health-system cost per induction was INR 3,545 (USD 42.26) for SOC vs INR 2,690 (USD 32.06) for TABI (24% lower). In the out-of-pocket expenditure (OOP) sub-sample, mean direct patient costs were INR 1,857 (USD 22.13) for SOC vs INR 776 (USD 9.24) for TABI (P < 0.001); mean indirect costs were INR 1,502 (USD 17.91) vs INR 766 (USD 9.13). Total mean societal cost per patient was INR 6,904 (USD 82.33) for SOC vs INR 4,232 (USD 31.88) for TABI (39% saving). Treatment retention was similar between groups (SOC: 76% vs TABI: 82%; P = 0.339), and both demonstrated comparable improvements in QoL at 1 week (84.00 vs 84.17; P = 0.912). Conclusion: Compared with standard induction, TABI substantially reduces health-system and patient costs, while maintaining comparable short-term retention and QoL. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|