A critical appraisal of the Australian comparative trial of methadone and buprenorphine maintenance

Drug and Alcohol Review
John Caplehorn, Jonathan J Deeks

Abstract

While there are serious problems with the analyses and reports, the Australian comparative trial of methadone and buprenorphine maintenance has generated very useful data. Contrary to the triallists' conclusions, their study provides good evidence that methadone is better than buprenorphine at retaining addicts in programmes where clinicians can adjust their patients' daily doses. The trial also provides the first evidence that methadone is significantly cheaper than buprenorphine maintenance. The savings from less frequent clinic attendance were more than offset by the extra time spent dispensing buprenorphine and the greater cost of the buprenorphine itself. In cost-effectiveness terms, the trial's results show methadone 'dominates' buprenorphine as an opioid maintenance drug because it is not only more effective but also cheaper.

References

Mar 1, 1978·Archives of General Psychiatry·R J Harford, H D Kleber
Sep 6, 2003·Drug and Alcohol Dependence·Christopher M DoranJames Bell

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Citations

Mar 26, 2010·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·M FischerC Haasen
Oct 3, 2006·Current Opinion in Psychiatry·Christian Haasen, Wim van den Brink
Nov 2, 2011·Journal of Addiction Medicine·Mark L KrausUNKNOWN American Society Of Addiction Medicine
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Jun 5, 2007·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Adegboyega Oyemade

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