title: Cost-effectiveness analysis of a continuing care intervention for cocaine-dependent adults.
abstract: BACKGROUND
  The study conducts a cost-effectiveness analysis (CEA) of a continuing care Telephone Monitoring and Counseling (TMC) intervention for adults diagnosed with cocaine dependence. Participants were randomly assigned to a control condition of intensive outpatient treatment only (treatment-as-usual, or TAU; N=108), or to one of two treatment conditions featuring TMC (N=106) and TMC plus incentives (TMC-plus; N=107). Follow-up assessments were conducted over a 2-year period.
  
  
  METHODS
  Intervention and client costs were collected with the program and client versions of the Drug Abuse Treatment Cost Analysis Program (DATCAP). Effectiveness was measured as the number of days abstinent during follow-up. Secondary analyses consider alternative measures of effectiveness and the reduced societal costs of physical and mental health problems and criminal justice involvement.
  
  
  RESULTS
  From the societal perspective, TMC dominates both TAU and TMC-plus as a cost-effective and cost-saving intervention. Results varied by substance-using status, however, with the subgroup of participants in TMC-plus that were using drugs at intake and early in treatment having the greatest number of days of abstinence and generating similar savings during follow-up than the TMC subgroup using drugs at intake.
  
  
  CONCLUSIONS
  Telephone monitoring and counseling appears to be a cost-effective and potentially cost-saving strategy for reducing substance use among chronic substance users. Providing client incentives added to total intervention costs but did not improve overall effectiveness.
  
  
  BACKGROUND
  Clinical Trials.gov Number: NCT00685659.
authors.affiliation: Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: kmccolli@miami.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: McCollister
authors.affiliation: Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.
authors.forename: Xuan
authors.initials: X
authors.lastname: Yang
authors.affiliation: University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, United States.
authors.forename: James R
authors.initials: JR
authors.lastname: McKay
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000379:methods; D019970:Cocaine-Related Disorders / Q000191:economics* / Q000628:therapy*; D003266:Continuity of Patient Care / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000379:methods*; D003376:Counseling / Q000191:economics / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D013689:Telephone / Q000191:economics; D016896:Treatment Outcome; D055815:Young Adult
keywords: Continuing care; Cost-effectiveness analysis; Economic evaluation; Substance use disorders