Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI.
OBJECTIVE
To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment.


METHODS
A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines.


METHODS
Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates.


METHODS
The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission.


RESULTS
The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se.


CONCLUSIONS
This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.
French
Michael T
MT
Department of Economics, Pompeu Fabra University, Barcelona, Spain.
Salomé
Helena J
HJ
Sindelar
Jody L
JL
McLellan
A Thomas
AT
D000553:Ambulatory Care / Q000191:economics; D016739:Behavior, Addictive / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis / Q000379:methods*; D005240:Feasibility Studies; D017048:Health Care Costs; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D015143:Philadelphia; D015397:Program Evaluation / Q000379:methods*; D012107:Research Design; D016320:Substance Abuse Treatment Centers / Q000191:economics*; D019966:Substance-Related Disorders / Q000191:economics / Q000628:therapy*; D016896:Treatment Outcome