Behavioral Health:
Insights

SEPTEMBER 2024

Medication-Assisted Treatment Overview

MAT is the use of FDA-approved medications, combined with counseling and behavioral therapies, to treat SUDs, including AUD and OUD. Sector growth is being driven by insurance coverage extensions, increased prevalence and government initiatives.

MAT Introduction

  • Treatments include FDA-approved medications such as methadone, buprenorphine and naltrexone for OUD, and medications like disulfiram, acamprosate and naltrexone for AUD
  • Treatment settings include highly regulated Opioid Treatment Programs (OTP), Office-Based Opioid Treatment (OBOT) and Residential Treatment Centers
  • MAT is an especially attractive solution for OUD treatment, proven to reduce morbidity and mortality, decrease overdose deaths, increase treatment retention and reduce criminal activity
  • Treatment, if successful, typically lasts at least a year, with some patients even receiving treatment for the remainder of their life

MAT Market Growth

Cost Benefits of MAT

  • According to a 5-year cohort study of 1mm individuals, MAT therapy can prove to be cost effective in addition to lowering the number of overdose deaths
  • All forms of MAT (buprenorphine, methadone and naltrexone) are associated with cost savings in comparison to no treatment, yielding savings of $25,000 to $105,000 in lifetime costs per person
  • Individuals receiving treatment who achieve abstinence have significantly lower criminal justice costs compared to untreated individuals with OUD

Sources: SAMHSA, CDC, Pitchbook, other publicly available sources

Treatment Gap Persists Despite Increase in MAT Facilities

Treatment Gaps

OUD Total Addressable Market Penetration by MAT1

$s in billions

U.S. MAT Facilities

In actuals

Amount of People Receiving SUD in 20232

# of individuals aged 12 and older (in millions)

Sources: SAMHSA, CDC, Pitchbook, other publicly available sources
1 The undiagnosed and untreated population can expand the MAT market to $25 billion
2 Locations where people received treatment are not mutually exclusive (may report more than one setting) causing the total to exceed 132.8 million

Navigating Expansion in MAT: Tailwinds and Headwinds

66%
decrease in heroin overdose deaths over the past 14 years as access to methadone and buprenorphine increase
19.7%
of the MAT market is estimated to have been penetrated by providers
150M+
people live in designated mental health professional shortage areas
1 in 3
people live in designated mental health professional shortage areas
Tailwinds
1
While SUDs are increasing dramatically due to the prevalence of illicit drugs in the U.S., this is unfortunately expanding the already large target market for MAT providers
2
The market at large presents significant whitespace opportunities as the current patient population is largely underdiagnosed and undertreated, indicating room for expansion within the industry
3
Strong legislative efforts aiming to improve payor dynamics and reform stringent OUD treatment regulations, leading to enhanced patient access and reduced stigmatization
4
Evolving provider models focused on integrating MAT treatments into the broader healthcare market, thereby maintaining profitability and continuing to improve treatment outcomes
Headwinds
1
Patients in need of MAT services face ongoing challenges: willingness and readiness to receive MAT, disparities in program access and financial constraints, which deter the SUD population
2
The U.S. faces a significant shortage of mental health/addiction treatment professionals, with over 150 million people living in federally designated mental health professional shortage areas
3
The industry faces widespread false narratives claiming that MAT replaces one addiction with another, increases overdose risk and is only suitable for severe cases or short-term use
4
Though regulatory reformation efforts are in place and advancing, government officials remain skeptical about the efficacy of MAT, which is driving uncertainty regarding the timing of future reforms

Sources: SAMHSA, CDC, Pitchbook, other publicly available sources

Select Recent MAT Transactions

Date Target Acquirer Transaction Type
June 2024 Was acquired by Add-On
June 2024 Was acquired by Add-On
June 2024 Was acquired by Add-On
June 2024 Was acquired by Add-On
May 2024 Was acquired by Add-On
March 2024 Was acquired by Add-On
February 2024 Was acquired by Add-On
February 2024 Was acquired by Platform
February 2024 Was acquired by Add-On
February 2024 Was acquired by Add-On
February 2024 Was acquired by Add-On
February 2024 Was acquired by Add-On
January 2024 Was acquired by Add-On
January 2024 Was acquired by Platform
January 2024 Was acquired by Platform
December 2023 Was acquired by Add-On
November 2023 Was acquired by Add-On
November 2023 Was acquired by Platform

Sources: SAMHSA, CDC, Pitchbook, other publicly available sources

Regulatory Consideration: MOTA

The Modernizing Opioid Treatment Access Act (MOTA), introduced in Congress in March 2023, aims to streamline regulations to enhance opioid treatment. While it seeks to make it easier for providers to offer comprehensive care and promote MAT acceptance, concerns have been raised about its broader patient safety and care quality implications.

Current Regulatory State

  • Background – Over 3 million people in the U.S. suffered from OUD, with more than 100 thousand annual overdose deaths — about 90% involving illicit fentanyl — highlighting the need to balance access to care with patient safety
  • Current – The Senate HELP Committee passed regulations by the DEA and SAMHSA that require patients to visit OTPs daily for methadone treatment
  • During COVID-19, SAMHSA temporarily relaxed rules to permit longer take-home doses and telemedicine follow-up visits, but these adjustments were not intended as permanent solutions

Modernizing Opioid Treatment Access Act

  • Aims to destigmatize treatment for substance use disorder by promoting awareness and acceptance, ensuring individuals seeking help are treated with dignity and respect
  • Increases access to methadone treatment by allowing physicians to prescribe methadone to OUD patients outside of OTP settings, reducing the need for travel, emphasizing the integration of addiction treatment into general healthcare to improve accessibility
  • Concerns include the adequacy of primary care settings for methadone treatment, potential oversimplification of addiction care, and the risks associated with reducing regulatory oversight outside of specialized environments

Key MOTA Implications

February 1, 2024

MOTA awaits action from U.S. Senate

Increased access to methadone treatment
Greater integration of SUD into primary care
Reducing the strain on existing OTPs
Opportunity for OBOTs and OTPs to expand

Sources: SAMHSA, CDC, Pitchbook, other publicly available sources

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