Cost-effectiveness analysis

The Drug Treatment Outcomes Research Study (DTORS) assessed the outcomes, costs and benefits of drug treatment in England. Results obtained in the study were variable and affected by a very small number of outliers. However, they provided evidence that treatment was effective in improving health status and in reducing the costs of other health and social care services. Overall, the net benefits of structured drug treatment were estimated to be positive, both overall and at the individual level in around 80 per cent of cases, with a benefit-cost ratio of approximately 2.5:1. Small sample size prevented the estimation of robust net benefits for sample subgroups. However, the results are broadly generalisable to the population of people seeking structured drug treatment in England and Wales. There were limitations to the analysis, due to missing observations and follow-up data, and the use of self-report data to estimate service use, offending and health status. The absence of a control group not receiving treatment also means that it is not possible to ascribe with a high degree of confidence any observed changes in outcomes to structured drug treatment specifically. DTORS participants were individuals who had received triage and a care plan for drug treatment, and not all of these would have taken up or completed their courses of treatment. The reported results reflect the average over all individuals. Further, the analysis does not include the costs of ancillary services which might have been received prior to accessing treatment, for instance the costs of triage and care plans. More significantly, the costs of referral through schemes such as the Drug Interventions Programme are also excluded. (Author' s abstract)