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An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence.
- Source :
- Addiction; Sep2016, Vol. 111 Issue 9, p1616-1627, 12p, 2 Diagrams, 2 Charts, 3 Graphs
- Publication Year :
- 2016
-
Abstract
- Aims To determine whether the provision of contingencymanagement using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost-effective use of healthcare resources. Design A probabilistic cost-effectiveness analysis was conducted, using a decision-tree to estimate the short-term clinical and health-care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long-term clinical consequences and costs associated with hepatitis B infection. Settings and participants Data on attendance to vaccination from a UK cluster randomized trial. Intervention Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives. Measurement Life-time health-care costs and quality-adjusted life years discounted at 3.5% annually; incremental cost-effectiveness ratios. Findings The resulting estimate for the incremental life-time health-care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = -£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8-30). The probabilistic incremental cost per quality adjusted life-year gained of the contingency management programmewas estimated to be £6738 (95% CI = £6297-7172),with an 89% probability of being considered cost-effective at a threshold of £20 000 per quality-adjusted life years gained (97.60% at £30 000). Conclusions Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost-effective use of health-care resources in the UK as long as the incidence remains above 1.2%. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEPATITIS B vaccines
VACCINATION
COST effectiveness
CONTINGENCY theory (Management)
TREATMENT of drug addiction
ECONOMICS
CONFIDENCE intervals
DRUGS
HEPATITIS B
MEDICAL care costs
MOTIVATION (Psychology)
PATIENT compliance
PROBABILITY theory
RESEARCH funding
REWARD (Psychology)
INTRAVENOUS drug abusers
RANDOMIZED controlled trials
BEHAVIOR modification
DISEASE incidence
QUALITY-adjusted life years
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 09652140
- Volume :
- 111
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Addiction
- Publication Type :
- Academic Journal
- Accession number :
- 118089329
- Full Text :
- https://doi.org/10.1111/add.13385