PROTOCOL NIDA-CTN-0007-A-2


Economic Evaluations in the CTN -- Methods & Applications

Jody Sindelar, PhD
Lead Investigator
Division of Health Policy & Administration
Yale School of Public Health
jody.sindelar@yale.edu

This ancillary study is related to CTN-0006, "Motivational Incentives for Enhanced Drug Abuse Recovery: Drug Free Clinics," and CTN-0007, "Motivational Incentives for Enhanced Drug Abuse Recovery: Drug Free Clinics."

Abstinence-based incentives have been shown to improve treatment outcomes over usual care alone in community-based drug abuse treatment programs, but their cost-effectiveness has not been examined.  Economic analyses of cost-effectiveness are clinically important, as even if abstinence-based incentives are shown to be effective, they may have limited adoption within community-based treatment programs unless they are also shown to be cost-effective.  Therefore, we undertook an economic study of multi-site CTN clinical trials that used to evaluate cost-effectiveness.

PRIMARY FINDINGS

In both methadone-maintenance clinics and counseling-based drug-free clinics, abstinence-based incentives provided better treatment outcomes than usual care, but required additional costs.  Compared to usual care in counseling-based drug-free clinics, the incremental cost of using abstinence-based incentives to lengthen the longest duration of continuous stimulant and alcohol abstinence by 1 week was $258, and to obtain an additional stimulant-free urine sample was $146.  Compared to usual care in methadone-maintenance clinics, the incremental cost of using abstinence-based incentives to lengthen the longest duration of continuous stimulant and alcohol abstinence by 1 week was $141, and to obtain an additional stimulant-free urine sample was $70.  Adding abstinence-based incentives to usual care was more cost-effective in methadone-maintenance clinics than in counseling-based drug-free clinics.  Empirical analyses are needed to help policy makers decide whether abstinence-based incentives are worth the extra expense.

Results Articles:

Olmstead TA, et al. Clinic variation in the cost-effectiveness of contingency management. American Journal on the Addictions 2007;16(6):457-460. [get article]

Sindelar JL, et al. Cost-effectiveness of prize-based contingency management in methadone maintenance treatment programs. Addiction 2007;102(9):1463-1471. [get article]

Olmstead TA, et al. Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs. Drug and Alcohol Dependence 2007;87(2/3):175-182. [get article]

RELATED STUDIES
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Publications about CTN-0007-A-2


 

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 2/2011 -- http://ctndisseminationlibrary.org/protocols/ctn0007a2.htm
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