A cost-effectiveness analysis of modafinil therapy for psychostimulant dependence.
OBJECTIVE
To examine the cost-effectiveness of modafinil (200 mg daily) plus counselling compared with placebo for the treatment of psychostimulant dependence.


METHODS
Cost and outcome data were collected alongside two randomised controlled trials of modafinil 200 mg daily over 10 weeks for methamphetamine (n = 74) and cocaine dependence (n = 8), respectively. Incremental cost-effectiveness ratios representing the additional costs to achieve a given outcome were calculated for both the change in the number of stimulant-free days and quality-adjusted life years 12 weeks post-treatment.


RESULTS
The incremental cost-effectiveness ratio indicated that it would cost an additional $AUD79 to achieve an extra stimulant-free day with modafinil compared with placebo. This result was not statistically significant, but appeared to be a robust estimate after sensitivity analysis. Counselling, whether received within program or from other services, improved the cost-effectiveness of modafinil relative to placebo.


CONCLUSIONS
Strategies to improve the uptake of counselling are recommended as cost-effective.
Shearer
James
J
Peninsula Medical School, University of Exeter, Exeter, United Kingdom. shearerjames7@gmail.com
Shanahan
Marian
M
Darke
Shane
S
Rodgers
Craig
C
van Beek
Ingrid
I
McKetin
Rebecca
R
Mattick
Richard P
RP
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000188:drug therapy* / Q000191:economics* / Q000628:therapy; D001559:Benzhydryl Compounds / Q000191:economics* / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000191:economics* / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000191:economics* / Q000628:therapy; D003131:Combined Modality Therapy / Q000191:economics; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D019057:Quality-Adjusted Life Years
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil