Cost-utility analysis of methadone maintenance treatment in Lithuania.
BACKGROUND
Economic evaluations in health care involve the identification, measurement, valuation, and then comparison of the costs (inputs) and outcomes of treatments or preventive activities. The aim was to analyze the cost-utility of six-month methadone maintenance treatment program in a Lithuanian primary health care setting.


METHODS
A prospective study design was used. All the information was obtained through the validated questionnaires at the baseline and 3- and 6-month follow-ups. WHOQOL-BREF was used to assess the quality of life; the costs were assessed using the DATCAP methodology from the perspective of a patient and outpatient clinic during follow-up period.


RESULTS
A total of 102 opioid-dependent patients were recruited in the study; 512 follow-up patient-months were obtained. The methadone maintenance treatment has significantly improved physical, psychological, and environmental components of quality of life during follow-up. Total program costs were 61 288.87 EUR. Cost paid by a patient comprised about 31% of total program costs. Cost per quality-adjusted life-month (QALM) for physical domain was 2227.55 EUR; for psychological domain, 1879.50 EUR; for social domain, 5467.64 EUR; and for environmental domain, 4626.47 EUR. Costs per QALM and quality-adjusted life-year (QALY) for total quality of life in the maintenance program were 2864.00 EUR and 34 368.00 EUR, respectively.


CONCLUSIONS
Our results showed that 6-month methadone maintenance program was effective in the terms of quality-of-life improvement. Methadone maintenance treatment program was less effective in terms of cost per QALY.
Vanagas
Giedrius
G
Department of Preventive Medicine, Kaunas University of Medicine, 50009 Kaunas, Lithuania. giedrius.vanagas@kmu.lt
Padaiga
Zilvinas
Z
Bagdonas
Eugenijus
E
D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent; D008097:Lithuania; D008297:Male; D008691:Methadone / Q000191:economics / Q000627:therapeutic use*; D008962:Models, Theoretical; D009293:Opioid-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D011320:Primary Health Care; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012046:Rehabilitation / Q000191:economics*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
D008691:Methadone