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