Key PointsQuestionAre interventions to increase buprenorphine treatment initiation, duration, and capacity for treating opioid use disorder cost-effective?FindingsIn this quality and economic evaluation of modeled interventions to increase buprenorphine treatment initiation, duration, and capacity, we projected health outcomes and costs of 5 interventions and their combinations. This study found that a portfolio of interventions, including contingency management, hub-and-spoke clinician training, initiation of buprenorphine treatment in the emergency department, and telehealth, was the preferred strategy for a range of generally accepted willingness-to-pay thresholds.MeaningThe findings of this study suggest that interventions that increase buprenorphine treatment duration concurrently with treatment capacity are the most cost-effective and have the largest association with reducing overdose deaths.