Estimating the dollar value of health outcomes from drug-abuse interventions

被引:61
作者
French, MT
Mauskopf, JA
Teague, JL
Roland, EJ
机构
[1] GLAXO WELLCOME INC, PHARMACOECON RES, RES TRIANGLE PK, NC 27709 USA
[2] RES TRIANGLE INST, CTR ECON RES, RES TRIANGLE PK, NC 27709 USA
[3] RES TRIANGLE INST, SOCIAL & BEHAV RES CTR, RES TRIANGLE PK, NC 27709 USA
关键词
substance-abuse policy; health valuation; benefit-cost analysis; quality-adjusted life-year;
D O I
10.1097/00005650-199609000-00003
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVES. People who abuse drugs suffer from a host of medical problems that impose costs on both the abusers and society as a whole. Drug-abuse treatment and other interventions can help alleviate these medical problems, leading to health status improvements for chronic drug users and reduced social costs. The authors' dual purpose here is to (1) propose a theoretically rigorous yet easy-to-apply methodology for estimating the health-related costs of drug abuse and (2) demonstrate the methodology by estimating the potential dollar value of avoiding adverse health consequences as a result of successful drug-abuse interventions. METHODS. The authors' propsed multiattribute quality-adjusted life year methodology for estimating the value of avoiding morbidity and mortality involves eight steps to be followed sequentially. The framework is based on developing a common unit of well-being (ie, qualilty-adjusted life year) that can be applied to all types of health conditions. If: all health states can be denominated in this common unit, then the process of valuation is straightforward and consistent across all types of illnesses and diseases. The methodology is relatively inexpensive to execute because the estimation procedures are not complicated technically and the data demands are modest. Also, this approach incorporates elements from several disciplines, including psychology, epidemiology, medicine, and economics. Finally, the proposed methodology is flexible enough to cover a wide range of illnesses and diseases so that consistent and comparable estimates can be generated. RESULTS. The authors estimate the dollor value of avoiding acute hepatitis B, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hypertension, bacterial pneumonia, sexually transmitted diseases, and tuberculosis for a white male aged 32 years. The authors' results illustrate that estimated avoided morbidity values can vary significantly across the range of health consequences associated with drug abuse. At the upper end of the range, the value of avoiding only the morbidity associated with a single case of HIV/AIDS is approximately $157,811 for the period beginning with transmission of HIV, through late-stage HIV and AIDS, and ending just before death. CONCLUSIONS. People who abuse drugs suffer from many medical problems in addition to their addiction. The proposed approach for estimating the dollar value of avoiding adverse health consequences provides policy analysts, evaluators, and researchers a method to calculate theoretically based benefit estimates for use in a benefit-cost analysis of drug-abuse interventions.
引用
收藏
页码:890 / 910
页数:21
相关论文
共 98 条
[1]   HIV-INFECTION IN INTRAVENOUS-DRUG-USERS ENTERING DRUG-TREATMENT, UNITED-STATES, 1988 TO 1989 [J].
ALLEN, DM ;
ONORATO, IM ;
GREEN, TA ;
BLEDSOE, G ;
COLLIE, D ;
CONNELL, T ;
DEPPE, D ;
EDGAR, G ;
EFIRD, J ;
FORRESTER, W ;
MEEK, B ;
RUBERTI, D ;
SANDERS, R ;
SLOANE, S .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1992, 82 (04) :541-546
[2]  
[Anonymous], 1991, MMWR, V40
[3]  
[Anonymous], LAW CONT PROBLEMS
[4]  
[Anonymous], 1975, HOUSEHOLD PRODUCTION
[5]  
Anthony J C, 1991, NIDA Res Monogr, V110, P71
[6]   WAGE-RISK PREMIUMS AND WORKERS COMPENSATION - A REFINEMENT OF ESTIMATES OF COMPENSATING WAGE DIFFERENTIAL [J].
ARNOULD, RJ ;
NICHOLS, LM .
JOURNAL OF POLITICAL ECONOMY, 1983, 91 (02) :332-340
[7]   VALUING CHANGES IN HEALTH RISKS - A COMPARISON OF ALTERNATIVE MEASURES [J].
BERGER, MC ;
BLOMQUIST, GC ;
KENKEL, D ;
TOLLEY, GS .
SOUTHERN ECONOMIC JOURNAL, 1987, 53 (04) :967-984
[8]  
BERKOW R, 1992, MANUAL DIAGNOSIS THE
[9]   FINANCING AND COST OF STANDARD AND ENHANCED METHADONE TREATMENT [J].
BRADLEY, CJ ;
FRENCH, MT ;
RACHAL, JV .
JOURNAL OF SUBSTANCE ABUSE TREATMENT, 1994, 11 (05) :433-442
[10]   COCAINE-RELATED MEDICAL PROBLEMS - CONSECUTIVE SERIES OF 233 PATIENTS [J].
BRODY, SL ;
SLOVIS, CM ;
WRENN, KD .
AMERICAN JOURNAL OF MEDICINE, 1990, 88 (04) :325-331