A cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service

Substance Abuse Treatment, Prevention, and Policy

Research

Mike Irvine¹  Benjamin Enns²  Hena Quereshi³  William Rioux³  S. Monty Ghosh⁴  Jennifer Jackson⁵ 

[1] British Columbia Centre for Disease Control (BCCDC), Vancouver, BC, Canada;Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada;Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada;Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada;Department of Internal Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada;Faculty of Nursing, University of Calgary, Calgary, AB, Canada;

关键词: Mobile overdose response services;    Opioids;    Overdose;    Drug poisoning;    Cost analysis;    Emergency services;   

DOI  :  10.1186/s13011-023-00565-8

 received in 2023-05-24, accepted in 2023-09-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe overdose crisis continues across Canada which calls for novel harm reduction strategies. Previous research indicates that a majority of eHealth solutions are cost-effective however current literature on the cost-benefit of eHealth for harm reduction is sparse. The National Overdose Response Service (NORS) is a Canada-wide telephone-based harm reduction service. Service users can call the phone number and connect to a peer who can virtually monitor the substance use session and dispatch appropriate interventions in the case of overdose.Objectives of the research/projectWe aim to assess the cost-benefit of NORS by comparing the estimated cost-savings from prevented overdose mortality to the operating costs of the program, alongside healthcare costs associated with its operation.MethodsData around systems costs and operational costs were gathered for our calculations. Our primary outcome was cost-benefit ratios, derived from estimates and models of mortality rates in current literature and value of life lost. We presented our main results across a range of values for costs and the probability of death following an unwitnessed overdose. These values were utilized to calculate cost-benefit ratios and value per dollar spent on service provision by NORS over the length of the program’s operation (December 2020–2022).ResultsOver the total funded lifespan of the program, and using a Monte Carlo estimate, the benefit-to-cost ratio of the NORS program was 8.59 (1.53–15.28) per dollar spent, depending on estimated mortality rates following unwitnessed overdose and program operation costs. Further, we conservatively estimate that early community-based naloxone intervention results in healthcare system savings of $4470.82 per overdose response.ConclusionsWe found the NORS program to have a positive benefit-to-cost ratio when the probability of death following an unwitnessed overdose was greater than 5%. NORS and potentially other virtual overdose monitoring services have the potential to be cost-effective solutions for managing the drug poisoning crisis.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023