Researching Effective Strategies to Prevent Opioid Death (RESPOND)

Boston Medical Center, Boston MA

Investigators

Linked publications & trials

Abstract

Recent surveillance data indicate that the United States may be making progress mitigating the harms of the overdose epidemic. In multiple states, rates of overdose death have fallen slightly for two consecutive years. Yet, despite this welcome news, rates continue to rise in some places and among some populations. While differences in opioid supply could explain some variations in overdose death, the ways that we implement opioid treatment could also drive them. It is therefore essential that we investigate how implementation of policy and interventions to address the opioid crisis impacts the distribution of costs and of benefits among jurisdictions and populations. The Researching Effective Strategies to Prevent Opioid Death (RESPOND) is simulation model OUD and OUD treatment delivery in a state. RESPOND leverages investments in expanded public health data infrastructure to inform model parameters, and it catalyzes new uses of data from NIDA-funded implementation studies. We use RESPOND to investigate the health benefits, costs, and cost-effectiveness of policy choices and health care delivery models to prevent opioid overdose. In the previous funding period, we developed RESPOND and published studies projecting public health and health economic impacts of expanding the availability of medications for opioid use disorder (MOUD) in a variety of settings. We are currently expanding RESPOND to simulate outcomes in Kentucky, Ohio, and New York. We propose now to enhance RESPOND to investigate outcomes at both the total population level, and among subgroups of interest in the response to the opioid epidemic, for example, rural communities and incarcerated women. We will then use the model to investigate health economic impacts of policies regulating prescribing for medications for OUD and innovative care delivery models for people with OUD. We will perform distributional cost-effectiveness analyses, which is an emerging and innovative method to investigate the distribution of costs and benefits across society. Our specific aims are: Aim 1: To enhance the RESPOND model such that it provides detailed projections of the effectiveness of policies and interventions to prevent overdose among subgroups that continue to have a rising rate of overdose death.  Aim 2: To use RESPOND to perform distributional cost-effectiveness analyses of changing policies regulating MOUD prescribing. Aim 3: To employ RESPOND to investigate the clinical and economic value of interventions that support people who use drugs along each step of the OUD care cascade. We use RESPOND to generate evidence to guide large-scale implementation of policies and interventions to prevent overdose.