| Summary: | In 2013, Suboxone (buprenorphine/naloxone) became available as a generic and its direct cost, and cost differential with methadone, decreased. Buprenorphine/naloxone has several advantages compared with methadone. Methadone is a full agonist; there is no ceiling to respiratory depression or sedation effects and an overdose can be fatal. Buprenorphine also has a long half-life but because it is a partial agonist, it has a ceiling effect (effect plateaus at higher doses) and thus the risk of overdose is decreased. Other advantages of buprenorphine/naloxone include its long duration of action which allows for every second day dosing if needed; its administration as a sublingual tablet; its lack of requirements of an exemption to be prescribed; and its formulation with less potential for abuse. Given the foregoing, an assessment is required to assist decision-makers and prescribers in selecting between the two treatments. Hence, the purpose of this review is to provide evidence on the comparative clinical effectiveness and cost-effectiveness of buprenorphine/naloxone compared with methadone, for the treatment of patients with opioid use disorder. Clinical practice guidelines will also be examined
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