Virtual Opioid Use Disorder Solutions

Opioid use disorder is a significant public health crisis, affecting more than 9 million adults across the United States and contributing to approximately 80,000 deaths from overdose each year. The U.S. spends $111 billion annually on direct healthcare costs for OUD. 

Despite the availability of highly effective medications, only 25% of adults in need of OUD treatment receive a medication-based intervention. Individuals with OUD face significant barriers to receiving medications for opioid use disorder (MOUD) based treatment, including limited provider availability, onerous and fragmented care requirements, medication availability, and societal stigma. 

Virtual OUD solutions include medication-focused solutions that offer virtual prescribing with optional therapy and peer support, as well as digital wraparound solutions that complement existing treatment programs with services like contingency management and care navigation. These solutions aim to improve treatment retention and expand access to MOUD treatment.

Report contributors and reviewers provided important expertise and insight throughout our process. Those who directly contributed to the report have no relevant conflicts of interest to disclose.​

PHTI’s evaluation indicates that virtual solutions for opioid use disorder are as effective as usual, medication-based treatment and can help people stay on treatment slightly longer—an average of 13 more days over six months. However, despite growing investment and adoption, there is no clear evidence that these digital solutions have meaningfully reduced the overall cost of care or expanded participation in OUD treatment.

Medication-focused solutions may be substituted for usual care with comparable or slightly lower spending but show no substantial improvements in clinical outcomes or access expansion. Digital wraparound solutions increase net spending for purchasers because solution prices exceed avoided healthcare costs.  

• Advance evidence generation to demonstrate which aspects of virtual OUD solutions are improving treatment retention and for which populations.
• Expand access by focusing on patient acquisition and engagement to bring a broader range of patients into MOUD treatment and keep them in treatment longer.
• Improve care coordination by integrating virtual OUD solutions more effectively into the healthcare delivery system.
• Leverage opioid settlement funds for OUD support services and evidence-based approaches to OUD treatment.
• Expand the availability and uptake of MOUDs by promoting comprehensive coverage and addressing access barriers to long-acting formulations such as injectable buprenorphine and naltrexone.
• Modernize federal and state policy by finalizing Drug Enforcement Administration (DEA) teleprescribing rules, expanding licensure flexibilities, and investing in rigorous evaluations of digital OUD models and support services tools.