Last month, at the Research Society on Alcohol Annual Meeting in San Antonio, 3rd year CHOICE PhD student Thomas Hopkins, PharmD, MS presented a poster on a timely question in alcohol use disorder (AUD) treatment: Is long-acting injectable naltrexone (LAI-NTX) cost-effective compared to the daily oral formulation?
Using a Markov model with a lifetime horizon, Tom and his co-authors — Louis P. Garrison, Emily Williams, and Douglas Barthold — assessed direct medical costs and quality-adjusted life years (QALYs) across five health states that capture alcohol use and its sequelae. Their base case analysis found that LAI-NTX was dominated by PO-NTX under current pricing — a result driven largely by the significant cost differential between the two formulations.
The research also points to an important gap: existing evidence doesn’t yet adequately capture the adherence advantages of long-acting formulations or variation across patient subpopulations — precisely the factors that make LAI-NTX clinically compelling in the real world. Tom’s work lays the foundation for future cost-effectiveness analyses that can account for these dynamics.
“Additional analyses are underway to address the impact of medication adherence and drug pricing changes,” Hopkins said. “In the context of new medications being potentially repurposed for alcohol use disorder and other addictions, these results underscore the importance of including real-world factors, such as adherence, into the cost-effectiveness framework.”
Congratulations, Tom, on a strong showing at RSA 2026!