impact of abuse deterrent opioids on street prices
TRANSCRIPT
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