Measuring benefits of opioid misuse treatment for economic evaluation: health‐related quality of life of opioid‐dependent individuals and their spouses as assessed by a sample of the US population
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Aims: To understand how the general public views the quality of life effects of opioid misuse and opioid use disorder on an individual and his/her spouse, measured in terms used in economic evaluations. Design: Cross‐sectional internet survey of a US population‐representative respondent panel conducted December 2013–January 2014. Setting: United States. Participants: A total of 2054 randomly selected adults; 51.1% male (before weighting). Measurements: Mean (95% confidence interval) and median health ‘utility’ for six opioid misuse and treatment outcomes: active injection misuse; active prescription misuse; methadone maintenance therapy at initiation and when stabilized in treatment; and buprenorphine therapy at initiation and when stabilized. Utility is a numerical representation of health‐related quality of life used in economic evaluations to ‘adjust’ estimated survival to include peoples’ preferences for health states. Utilities are determined by surveying the general population to estimate the value they assign to particular health states on a scale where 0 = the value of being dead and 1.0 = the value of being in perfect health. Spouse spillover utility is assigned to a spouse of an individual who is in a particular health state. Findings: Mean individual utility ranged from 0.574 [95% confidence interval (CI) = 0.538, 0.611] for active injection opioid misuse to 0.766 for stabilized buprenorphine therapy (95% CI = 0.738, 0.795), with other states in between. Female respondents assigned higher utility to the active prescription misuse and buprenorphine therapy at initiation states than did males (P < 0.05); all other states did not differ by respondent gender. Mean spousal utilities were significantly lower than 1.0 but mostly higher than individual utility, and were similar between male and female respondents. Conclusions: In the opinion of the US public, injection opioid misuse results in worse health‐related quality of life than prescription misuse, and methadone therapy results in worse health‐related quality of life than buprenorphine therapy. Spouses are negatively affected by their partner's opioid misuse and early treatment.
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The study valued lost health-related quality of life only for individuals with OUD; there is likely a substantial reduction in quality of life for friends and family members who care for loved ones with use disorder or lose loved ones to overdose.
“We also only value lost HRQL for individuals with opioid use disorder. There is likely a substantial reduction in quality of life for friends and family members who care for loved with use disorder, and lose loved ones to overdose (Wittenberg et al., 2016).”
From The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017 (2021) · cites this paper as Wittenberg et al., 2016
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Experimental — accuracy not yet measuredThe HRQOL weights used for OUD were based on a survey of 1,178 participants from the US population.
“These HRQOL weights are based on a survey of 1,178 participants from the US population to assess the reduction in quality of life based on whether or not a person with opioid use disorder was currently using opioids either by injection or prescription opioid misuse”
From The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017 (2021) · cites this paper as Wittenberg et al., 2016
The Results report 1,178 respondents in the individual-focused survey, which assessed opioid-misuse health states. But the survey had 2,054 respondents overall, and the Methods (Study design) say responses from the 876-person spouse-spillover version also supplemented the individual utility data. Thus 1,178 is not the full survey sample underlying the weights. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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- Authors
- Wittenberg, E., Bray, J. W., Aden, B., Gebremariam, A., Nosyk, B., & Schackman, B. R.
- Affiliations
- Harvard University (US)
- University of North Carolina at Greensboro (US)
- Weill Cornell Medicine (US)
- University of Michigan (US)
- Simon Fraser University (CA)
- Corresponding author
- Wittenberg, Eve
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2015-12-17
- Volume
- 111
- Issue
- 4
- Pages
- 675-684
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC5034732
- OpenAlex
- W1831354172
- Cited by
- 45
- References
- 42
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 2
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA033424)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- opioid use disorder, opioid misuse, health-related quality of life, health utility, intravenous drug use, prescription opioid misuse, methadone maintenance treatment, buprenorphine, public preferences
- MeSH terms
- Adolescent, Adult, Aged, Attitude to Health, Cost-Benefit Analysis, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Opioid-Related Disorders, Quality of Life, Surveys and Questionnaires, United States, Spouses, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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