The prevalence of opioid use disorder (OUD) – the chronic use of opioids that causes clinically significant distress and impairment - has been trending upward since the 1990’s and affects over 2.1 million people in the U.S. A 2009 study by Jones et al examined cost for office-based buprenorphine/naloxone (OB), clinic-based methadone (MC) and office-based methadone (OM) OUD treatment. The authors analyzed differences in costs alone on the basis of inability to detect any statistical differences in outcomes, finding that MC treatment was cheapest. The goal of health economic evaluation is estimation over hypothesis testing and a joint consideration of costs and effects is appropriate. We analyzed cost-effectiveness of these treatment alternatives based on available point estimates for effectiveness and cost. Jones et al provided point estimates for outcomes (percent patients retained on treatment and percent opioid-positive urine tests) and monthly per-patient costs, enabling calculations of incremental cost-effectiveness ratios (ICERs) . We estimated ICERs as cost per opioid-free month gained and cost per additional patient retained in treatment from the healthcare perspective. OB was dominated by OM using either the retention or opioid-negative test outcome. The ICERs for OM relative to MC were: $5,544 per additional patient retained in treatment; $760 per opioid-free month gained. Jones et al concluded that MC was cheapest. Our cost-effectiveness approach indicates that OM may be cost-effective, depending on the value of the outcomes generated. Clarity on acceptable willingness to pay thresholds for these outcomes and investigations into possible heterogeneity among patients would further inform cost-effectiveness and treatment decisions. Regulations currently restrict methadone administration to a clinic-based setting. Among potential strategies to address the opioid crisis, policymakers might consider not only patient access benefits but also the economic advantages of expanding regulatory scope of methadone to the office-based setting.