Opioid Use Disorder Costs $163K Per Case Annually to Payers and Government; Medication-Assisted Treatment Shows Net Savings

Avalere's national and state-level modeling quantifies the economic burden of opioid use disorder at nearly $1 trillion annually, with state and local government costs ranging from $137 to $524 per capita depending on geography. The analysis demonstrates that medication-assisted treatments—including methadone, buprenorphine formulations, and behavioral therapy—generate significant per-case cost savings, a finding directly relevant to Medicaid MCO benefit design, utilization management policies, and state pharmacy carve-in/carve-out decisions. With Medicaid covering a disproportionate share of individuals with substance use disorders, these cost-offset calculations inform managed care contracting, quality incentives, and state budget planning.

Behavioral Health · Managed Care · Pharmacy

This is outside commentary from Avalere, not part of Medicaid Monitor's independently scored news coverage.

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