impact of abuse deterrent opioids on street prices

Impact of Abuse Deterrent Opioids onStreet Prices

Nabarun DasguptaChief Data Scientist

Epidemico, Inc.

RADARS System Annual Meeting

Washington, DC

May 6, 2016

Slides at @epidemico

External Referrals

Find TreatmentSAMHSA, ADIN, DroguesInfoService.fr, L’ANAPAA, DBDD

Overdose PreventionMedication safety sites, HRC, naloxone

Safe Storage, Disposal & TakebackFDA, Health Products Stewardship AssociationSafe Pain Management & AdvocacyCanadian Pain Coalition, PainAustralia.org, RBK StuttgartHarm ReductionHRC, EuroHRN

Unique Visitors per Day

2501641

24393252

MobileAccounts for 74%

of visits

Search87% of visits come from

organic search

1.2 Million visitors per year

2013

2016

Visitor DemographicsBased on 58% of known demographics from Google account users

19%Male

35+ years-old

40%Male

18-34 years-old

16%Female35+ years-old

23%Female18-34 years-old

As captured by Google Analytics. January 1 through March 31, 2016

7.0%

6.4%

5.8%

4.6%

Who is Likely to Submit a Price?Percent of visitors, 58% of known Google Account users, 1Q2016

18-24 years-old

25-34 years-old

35-44 years-old

45+ years-old

MethodsDo different deterrence strategies result in discernible street price differences?

STEP 1

STEP 3STEP 2

STEP 4

USA Data in USDNov 1, 2010 through Apr 30, 2016Solid oral formulations Compare unprotected to ADF price per milligram, within active ingredient

Geometric means and 95% CIN = 139,434Non-parametric Wilcoxan rank-sum (Mann-Whitney) tests

(Partial-) Antagonists: Subutex vs. SuboxoneProdrugs: morphine vs. codeine; Vyvanse vs. Adderall

Phyical barriers: Zohydro vs. IR hydrocodone vs. Hysingla ER; OxyContin OC vs. OP;Opana ER original vs. reformulation; Xartemis XR vs. IR oxycodone;

IR hydromorphone vs. Exalgo; Ritalin vs. Concerta; morphine

Not enough data to evaluate yet:Targin(iq), Oxytrex, Oxecta, Quillivant XR, Talwin, Amrix, Xtampza ER,

MorphaBond

Hydromorphone

$2.63/mg

Oxymorphone

$1.47/mg

Hydrocodone$0.79/m

g

Oxycodone$0.92/m

g

Morphine

$0.36/mg

Buprenorphine$2.12/m

g (Suboxone)

Tapentadol$0.15/m

g

Methylphenidate

$0.36/mg

Amphetam

ine$0.36/m

g

Percent Discount for ADF VersionsPutative abuse-deterrent formulation versus unprotected formulations with same active ingredient, using statistical comparison that is less influenced by outliers.

3% 0% 49%

52%

26%

18%

35%

41%

52%

Physical Barrier Prodrug(Partial-)Antagonist

Conc

erta

Exal

go

Opa

na E

R

Oxy

Conti

n O

P

Zohy

dro

ER (1

st)

Vyva

nse

code

ine

Subo

xone

tabl

et

Xart

emis

XR

p<.01

Z 24

p<.01

Z 57

p<.01

Z 5.9

p<.02

Z 2.4

p=.02

Z 2.4

p<.01

Z 9.1

p<.01

Z 19

p=.58

Z 0.5

p=.48

Z .71

Subo

xone

Film

3% 24%

Rita

lin L

A

p<.01

Z 4.1

27%

Nuc

ynta

ER

p=.05

Z 1.9

51%

Hysin

gla

ERp<.0

1Z 4.0

p=.67

Z .43