Cost-effectiveness of flexible take-home buprenorphine-naloxone versus methadone for treatment of prescription-type opioid use disorder

•Cost-effectiveness analyses of competing OAT medications are rare.•Flexible take-home buprenorphine-naloxone was not cost-effective versus methadone.•Differences were driven by lower treatment retention in buprenorphine-naloxone.•Cost-effectiveness results were explored in a range of sensitivity analysis.•Increased fentanyl prevalence favored methadone..