A cost-effectiveness analysis of heroin detoxification methods in the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD).
This economic evaluation was part of the Australian National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) project. Data from four trials of heroin detoxification methods, involving 365 participants, were pooled to enable a comprehensive comparison of the cost-effectiveness of five inpatient and outpatient detoxification methods. This study took the perspective of the treatment provider in assessing resource use and costs. Two short-term outcome measures were used-achievement of an initial 7-day period of abstinence, and entry into ongoing post-detoxification treatment. The mean costs of the various detoxification methods ranged widely, from AUD 491 dollars(buprenorphine-based outpatient); to AUD 605 dollars for conventional outpatient; AUD 1404 dollars for conventional inpatient; AUD 1990 dollars for rapid detoxification under sedation; and to AUD 2689 dollars for anaesthesia per episode. An incremental cost-effectiveness analysis was carried out using conventional outpatient detoxification as the base comparator. The buprenorphine-based outpatient detoxification method was found to be the most cost-effective method overall, and rapid opioid detoxification under sedation was the most cost-effective inpatient method.
National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW 2052, Australia. M.Shanahan@unsw.edu.au
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Shanahan
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Doran
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Digiusto
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Bell
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Lintzeris
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White
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Ali
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Saunders
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Mattick
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Gilmour
D000328:Adult; D000701:Analgesics, Opioid / Q000191:economics* / Q000627:therapeutic use; D000704:Analysis of Variance; D002047:Buprenorphine / Q000191:economics / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008691:Methadone / Q000191:economics / Q000627:therapeutic use; D009271:Naltrexone / Q000191:economics / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000191:economics* / Q000627:therapeutic use
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009292:Narcotic Antagonists; D002047:Buprenorphine; D009271:Naltrexone; D008691:Methadone