Cost and cost-effectiveness of interim methadone treatment and patient navigation initiated in jail.
Drug Alcohol Depend
; 217: 108292, 2020 12 01.
Article
en En
| MEDLINE
| ID: mdl-32992151
BACKGROUND: Individuals with opioid use disorder (OUD) who are released from pre-trial detention in jail have a high risk of opioid relapse. While several interventions for OUD initiated during incarceration have been studied, few have had an economic evaluation. As part of a three-group randomized trial, we estimated the cost and cost-effectiveness of a negative urine opioid test. Detainees were assigned to interim methadone (IM) in jail with continued methadone treatment post-release with and without 3 months of post-release patient navigation (PN) compared to an enhanced treatment-as-usual group. METHODS: We implemented a micro-costing approach from the provider's perspective to estimate the cost per participant in jail and over the 12 months post-release from jail. Economic data included jail-based and community-based service utilization, self-reported healthcare utilization and justice system involvement, and administrative arrest records. Our outcome measure is the number of participants with a negative opioid urine test at their 12-month follow-up. We calculated incremental cost-effectiveness ratios (ICERs) for intervention costs only and costs from a societal perspective. RESULTS: The average cost of providing patient navigation services per individual beginning in jail and continuing in the community was $283. We find that IM is dominated by ETAU and IM + PN. Per additional participant with a negative opioid urine test, the ICER for IM + PN including intervention costs only is $91 and $305 including societal costs. CONCLUSIONS: IM + PN is almost certainly the cost-effective choice from both an intervention provider and societal perspective.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Análisis Costo-Beneficio
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Tratamiento de Sustitución de Opiáceos
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Navegación de Pacientes
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Cárceles Locales
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Metadona
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Trastornos Relacionados con Opioides
Tipo de estudio:
Clinical_trials
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Health_economic_evaluation
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Drug Alcohol Depend
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Irlanda