Cost-Effectiveness Analysis of a Continuing Care Intervention for Cocaine-Dependent Adults
INTRODUCTION:
The
study conducts a cost-effectiveness analysis (CEA) of a continuing care
Telephone Monitoring and Counseling (TMC) intervention for adults diagnosed
with cocaine dependence. Participants were randomly assigned to a control
condition of intensive outpatient treatment only (treatment-as-usual, or TAU;
N=108), or to one of two treatment conditions featuring TMC (N=106) and TMC
plus incentives (TMC-plus; N=107). Follow-up assessments were conducted over a
2-year period.
METHODS:
Intervention
and client costs were collected with the program and client versions of the
Drug Abuse Treatment Cost Analysis Program (DATCAP). Effectiveness was measured
as the number of days abstinent during follow-up. Secondary analyses consider
alternative measures of effectiveness and the reduced societal costs of
physical and mental health problems and criminal justice involvement.
RESULTS:
From the
societal perspective, TMC dominates both TAU and TMC-plus as a cost-effective
and cost-saving intervention. Results varied by substance-using status,
however, with the subgroup of participants in TMC-plus that were using drugs at
intake and early in treatment having the greatest number of days of abstinence
and generating similar savings during follow-up than the TMC subgroup using
drugs at intake.
CONCLUSIONS:
Telephone
monitoring and counseling appears to be a cost-effective and potentially
cost-saving strategy for reducing substance use among chronic substance users.
Providing client incentives added to total intervention costs but did not
improve overall effectiveness.
- 1Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: kmccolli@miami.edu.
- 2Department Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.
- 3University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, United States
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