Title

Cost-effectiveness of counselling as a treatment option for methamphetamine dependence

Document Type

Journal Article

Publisher

Taylor and Francis Inc.

School

Health and Wellness Institute

RAS ID

21562

Comments

Ciketic, S., Hayatbakhsh, R., Mcketin, R., Doran, C.M., Najman, J.M. (2015). Cost-effectiveness of counselling as a treatment option for methamphetamine dependence in Journal of Substance Use, 20(4), 239-246. Available here.

Abstract

Introduction and aims: Illicit methamphetamine (MA) use is an important public health concern. There is a dearth of knowledge about effective and cost-effective treatments for methamphetamine (MA) dependence in Australia. This article evaluates the cost-effectiveness of counselling as a treatment option for illicit MA use compared with no treatment option. Design and methods: Data are from 501 individuals recruited into Methamphetamine Treatment Evaluation Study (MATES). The population of MA users from MATES is extrapolated to a total number of 1000 MA users in the intervention group (counselling treatment) and control group (non-treatment group). A decision analytic model is developed that examines the costs and health outcomes [measures as quality adjusted life years (QALYs) gained] for the treatment and comparison group over a 3-year period. A societal perspective is adopted and model inputs are subject to sensitivity and uncertainty analysis to test the robustness of results to parameter variability. Results are discounted by using 3% discount rate and expressed in 2011 Australian dollars. Results: The incremental cost-effectiveness analysis suggests that counselling is a dominant health care intervention, i.e. saves money and is more effective than a do nothing intervention. The incremental difference in costs is -AU$18.36 million (95% CI -AU$22.80 million to -AU$14.31 million) and the incremental difference in QALY is 107 (95% CI -640 to 820) with a probability of 78.64% of counselling being a dominant and cost-effective treatment within the acceptable incremental cost-effectiveness ratio (ICER) of $63832 per QALY in the Australian society. The results of the sensitivity analysis show that the ICER is most sensitive to change in five major inputs: baseline utility, utility at 3 months, dealing crime costs, property crime costs and fraud crime costs. Discussion and Conclusions: The economic evaluation of the cost-effectiveness of counselling for MA dependence, as a first cost-effectiveness study to assess psychosocial treatment options for MA dependence, shows that greater investment in this cost-effective strategy will produce significant cost-savings and improve health outcomes as well as improve a lot of externality issues associated with drug use.

DOI

10.3109/14659891.2014.900580

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