Cost and cost-effectiveness of standard methadone maintenance treatment compared to enriched 180-day methadone detoxification.
AIMS: To compare the cost and cost-effectiveness of methadone maintenance treatment and 180-day methadone detoxification enriched with psychosocial services. DESIGN: Randomized controlled study conducted from May 1995 to April 1999. SETTING: Research clinic in an established drug treatment program....
| Publicado en: | Addiction Vol. 99; no. 6; pp. 718 - 727 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2004
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106761660&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106761660 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Jun2004 vid: 99 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106761660 106761660 2004130125 10.1111/j.1360-0443.2004.00728.x NLM15139870 106761660 ppf: 718 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Cost and cost-effectiveness of standard methadone maintenance treatment compared to enriched 180-day methadone detoxification. aug: au: Masson CL Barnett PG Sees KL Delucchi KL Rosen A Wong W Hall SM affil: Department of Psychiatry, San Francisco General Hospital, 1001 Potrero Avenue, Bldg., 20, Suite 2100, San Francisco, CA 94110; masson@itsa.ucsf.edu sug: subj: Methadone Economics Substance Use Rehabilitation Programs Economics Substance Use Rehabilitation Programs Methods Clinical Trials Confidence Intervals Costs and Cost Analysis Mann-Whitney U Test Random Assignment Research Instruments Support, Psychosocial T-Tests Human ab: AIMS: To compare the cost and cost-effectiveness of methadone maintenance treatment and 180-day methadone detoxification enriched with psychosocial services. DESIGN: Randomized controlled study conducted from May 1995 to April 1999. SETTING: Research clinic in an established drug treatment program. PARTICIPANTS: One hundred and seventy-nine adults with diagnosed opioid dependence. Intervention Patients were randomized to methadone maintenance (n = 91), which required monthly 1 hour/week of psychosocial therapy during the first 6 months or 180-day detoxification (n = 88), which required 3 hours/week of psychosocial therapy and 14 education sessions during the first 6 months. MEASUREMENTS: Total health-care costs and self-reported injection drug use. A two-state Markov model was used to estimate quality-adjusted years of survival. Findings Methadone maintenance produced significantly greater reductions in illicit opioid use than 180-day detoxification during the last 6 months of treatment. Total health-care costs were greater for maintenance than detoxification treatment ($7564 versus $6687; P < 0.001). Although study costs were significantly higher for methadone maintenance than detoxification patients ($4739 versus $2855, P < 0.001), detoxification patients incurred significantly higher costs for substance abuse and mental health care received outside the study. Methadone maintenance may provide a modest survival advantage compared with detoxification. The cost per life-year gained is $16 967. Sensitivity analysis revealed a cost-effectiveness ratio of less than $20 000 per quality-adjusted life-year over a wide range of modeling assumptions. CONCLUSIONS: Compared with enriched detoxification services, methadone maintenance is more effective than enriched detoxification services with a cost-effectiveness ratio within the range of many accepted medical interventions and may provide a survival advantage. Results provide additional support for the use of sustained methadone therapy as opposed to detoxification for treating opioid addiction. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|