Brandeis-led study shows pharmacy-based methadone treatment could benefit patients and the bottom line

Brandeis Stories

Brandeis-led study shows pharmacy-based methadone treatment could benefit patients and the bottom line

By Steve Foskett
March 16, 2026

A new study led by Brandeis University researchers found that pharmacy-based methadone dispensing models could operate profitably while widening access to a key service that reduces overdose deaths and supports recovery from opioid use disorder.

The first-of-its-kind study, published in the March 16 edition of the Journal of the American Medical Association's JAMA Network Open and conducted in collaboration with researchers at Boston University and the University of Rhode Island (URI), comes as many healthcare providers and treatment advocates are calling for more widespread availability of methadone, a standard medication used to treat opioid use disorder.

Structured as an economic evaluation, the study assessed two separate models that would allow methadone access through pharmacies. Using a "pharmacist-dispensed" model in which medical professionals prescribe and pharmacists dispense methadone directly, researchers estimated a return of $2.64 per dollar spent, for a net profit of $23,844 over three years.

Looking at a pharmacy-based "medication unit" model, in which established opioid treatment programs could extend their services to pharmacies where methadone would be dispensed, the study found the estimated return jumped to $3.53 per dollar spent, for a net profit of $96,904 over three years.

"Frankly, we were surprised that both scenarios generated such high return on investment, which bodes well for policymakers who want to increase access to treatment while at the same time supporting local businesses," said Cynthia A. Tschampl, a research scientist at the Heller School for Social Policy and Management at Brandeis, and the lead author on the study.

Under current federal law and regulations, methadone may be administered or directly dispensed only by federally certified opioid treatment programs, with rare exceptions. The medication unit model is permissible under current law, while the pharmacist-dispensed model is possible with a broadening of interpretation by the U.S. Drug Enforcement Administration.

"It is a disservice to your patient if you start something and later say 'I can't keep doing this because it's not financially viable,'" said Jeffrey Bratberg, URI College of Pharmacy professor and co-investigator on the project. "Pharmacies are struggling financially. If a pharmacy is your only choice for access to a medication and they go out of business, you lose all access to all medications. Our findings show offering methadone in pharmacies does not have that risk."

Used since the 1960s for treatment of opioid use disorder, methadone is a synthetic opioid that reduces cravings and withdrawal. The new study notes that methadone has been proven a highly effective treatment, but there remain significant barriers. There are around 2,100 opioid treatment programs in the U.S., but 80% of counties - including the entire state of Wyoming - lack even one program.

Supported by The Pew Charitable Trusts, the study surveyed various stakeholders, including people prescribed methadone, operators, public and private payers, and state and federal policymakers. It concluded that while pharmacies nationwide struggle to stay open, this new economic analysis could support pharmacies in making informed decisions about financial risks involved in expanding their business models.

"We've seen an over-28% reduction in overdose deaths recently in the U.S, which is encouraging," said Traci Green, Professor and Director of the Opioid Policy Research Collaborative at Brandeis and senior author of the paper. "We need accessible medication treatment with methadone to support people, not only to help them survive but to set them up to thrive. It doesn't get more accessible than your local pharmacy, and this study shows that's not just a logistical advantage for patients, but also a financial one for pharmacists."

In addition to Tschampl, Green, and Bratberg, the research team for the study included Elena Soranno, an undergraduate research assistant at The Heller School; Murray Dawson, a graduate research assistant at the Heller School; Sage Feltus, a research associate, and Maureen T. Stewart, research associate professor, at the Boston University School of Public Health.