Background:
Effective opioid agonist maintenance treatment (OAMT) programs are associated with halving HIV and HCV acquisition risk and improving access to testing and treatment, ART adherence, and service retention. Long-acting depot buprenorphine (LADB) could provide a more discreet, convenient, and less stigmatizing form of treatment for opioid dependence and the potential to improve client retention in care, as well as economic stability. However, lack of visibility of market size and demand in low- and middle-income countries (LMICs) has limited access to LADB. We estimated demand for LADB in LMICs to facilitate market entry and scale-up.
Methods:
We developed a deterministic model for estimating market size and demand for LADB based on people with opioid use disorder. We then layered OAMT program availability, and coverage, country by country to estimate the number of clients in the base year (2025). Finally, number of doses were estimated by multiplying the number of clients estimated in the base year by number of monthly maintenance doses required per year. The estimated doses in the base year were extrapolated cumulatively, informed by industry reports, to estimate demand in 2030.
Results:
The potential global market for LADB is estimated at approximately 210 million doses, equivalent to a market value of USD 63 billion. The demand for LADB is estimated at approximately 7.6 million doses in 2025 (47 LMICs), equivalent to a market value of USD 2.3 billion. This is estimated to grow to approximately 10.4 million doses (36%) by 2030. LADB could offer additional choice to scale-up access to HIV/HCV prevention and care to people who inject drugs.
Conclusions:
The market size and demand estimates demonstrate a viable market for LADB in LMICs. Further research is needed to understand the market enablers, constraints, feasibility, acceptability and willingness-to-pay to develop a compelling business case for LADB in LMICs. |