[Methadone maintenance programs with supplementary services: a cost-effectiveness study].
OBJECTIVE
Methadone maintenance programs (MMP) currently offer the best treatment for opioid-addicted patients. The aim of this study was to examine the cost-effectiveness of three MMPs that offered varying levels of supplementary services. Health-related quality of life was used as a measure of effectiveness.


METHODS
A 12-month follow-up study of 586 patients beginning methadone treatment in Drug Care Centers in Barcelona was performed. The Nottingham Health Profile was used to measure quality of life. Standard unit costs and total cost per patient were calculated from activity registries. Sociodemographic, health-related and toxicological data were collected through a semi-structured interview. A cost-effectiveness analysis was performed through two multiple linear regressions with the same adjusting variables.


RESULTS
The greater the number of supplementary services involved, the higher the costs. The adjusted models revealed a significant increase in health-related quality of life (an increase of 8% in the Nottingham Health Profile) and in costs (17%) between low- and medium-intensity programs.


CONCLUSIONS
The medium-intensity program showed the best cost-effectiveness ratio. However, the study's limitations preclude categoric generalization of the data.
Unitat de Recerca en Serveis Sanitaris. Institut Municipal d'Investigació Mèdica (IMIM). Barcelona. Spain. adomingo@imim.es
E
E
Puigdollers
F
F
Cots
M T
MT
Brugal
L
L
Torralba
A
A
Domingo-Salvany
F
F
Costas
D000328:Adult; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006291:Health Policy; D006801:Humans; D008297:Male; D008691:Methadone / Q000191:economics* / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D015397:Program Evaluation; D011788:Quality of Life; D012959:Socioeconomic Factors; D013030:Spain; D016320:Substance Abuse Treatment Centers / Q000191:economics*
D008691:Methadone