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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