Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs
Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs
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DOI：
10.1016/j.drugalcdep.2006.08.012
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发表时间：
2007-03-16
影响因子：
4.2
通讯作者：
Petry, Nancy A.
中科院分区：
文献类型：
--
作者：
Olmstead, Todd A.;Sindelar, Jody L.;Petry, Nancy A.
目的：评估基于奖励的干预措施作为兴奋剂滥用者常规护理的补充的成本效益。方法：本成本-效果分析基于国家药物滥用治疗临床试验网络实施的随机临床试验。该试验在八个社区门诊心理社会药物滥用治疗诊所进行。415名兴奋剂滥用者被分配到常规治疗组（N = 206）或常规治疗加戒除激励组（N = 209），为期12周。随机分配到激励条件的参与者有机会抽奖，以提交物质阴性样品；连续禁欲时间越长，抽到的次数越多。增量成本-效果比率估计比较基于奖励的激励相对于常规护理。患者的主要结果是最长时间的确认兴奋剂戒断（LDA）。单位成本是通过在八个参与的诊所进行的调查获得的。从临床试验中获得资源利用和患者结果。给出可接受度曲线，以说明样本的不确定性，并提供政策相关信息。结果：LDA延长1周的增量成本为258美元（95%置信区间为191-401美元）。对几个关键参数的敏感性分析表明，该值在163美元至269美元之间。结论：与常规护理组比较，激励组的lda明显延长，费用明显增高。2006爱思唯尔爱尔兰有限公司版权所有。
Objective: To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers.Methods: This cost-effectiveness analysis is based on a randomized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network. The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics. Four hundred and fifteen stimulant abusers were assigned to usual care (N = 206) or usual care plus abstinence-based incentives (N = 209) for 12 weeks. Participants randomized to the incentive condition earned the chance to draw for prizes for submitting substance negative samples; the number of draws earned increased with continuous abstinence time. Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care. The primary patient outcome was longest duration of confirmed stimulant abstinence (LDA). Unit costs were obtained via surveys administered at the eight participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information.Results: The incremental cost to lengthen the LDA by 1 week was US$ 258 (95% confidence interval, US$ 191-401). Sensitivity analyses on several key parameters show that this value ranges from US$ 163 to 269.Conclusions: Compared with the usual care group, the incentive group had significantly longer LDAs and significantly higher costs. (c) 2006 Elsevier Ireland Ltd. All rights reserved.