|Titre :||Economic benefits of substance use disorder treatment: A systematic literature review of economic evaluation studies from 2003 to 2021 (2023)|
|Auteurs :||E. FARDONE ; I. D. MONTOYA ; B. R. SCHACKMAN ; K. E. McCOLLISTER|
|Type de document :||Article : Périodique|
|Dans :||Journal of Substance Use and Addiction Treatment (Vol.152, September 2023)|
|Article en page(s) :||art. 209084|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus mots-clésECONOMIE ; EVALUATION ; TRAITEMENT ; EVOLUTION ; COUT ; BENEFICE ; CRIMINALITE ; INDICATEUR ; INTERVENTION ; THERAPIE COMPORTEMENTALE ; PHARMACOTHERAPIE
Introduction: The economic burden of substance use disorder (SUD) is significant, comprising costs of health care and social services, criminal justice resources, loss of productivity, and premature mortality. This study assembles and synthesizes two decades of evidence describing the benefits of SUD treatment across five main outcome domains; 1) health care utilization; 2) self-reported criminal activity by offense type; 3) criminal justice involvement collected from administrative records or self-reported; 4) productivity assessed through working hours or wages earned; and 5) social services (e.g., a day spent in transitional housing).
Methods: This review included studies if they reported the monetary value of the intervention outcomes, most commonly through a cost-benefit or cost-effectiveness framework. The search included studies from 2003 to the present day as of this writing (up to October 15, 2021). Summary cost estimates were adjusted using the US Consumer Price Index (CPI) to reflect the 12-month benefits per client in USD 2021. We followed the PRISMA methodology for study selection and assessed quality using the Checklist for Health Economic Evaluation Reporting Standards (CHEERS).
Results: The databases yielded 729 studies after removing duplicates, and we ultimately selected 12 for review. Studies varied widely regarding analytical approaches, time horizons, outcome domains, and other methodological factors. Among the ten studies that found positive economic benefits, reductions in criminal activity or criminal justice costs represented the largest or second largest component of these benefits (range $621 to $193,440 per client).
Conclusions: Consistent with previous findings, a reduction in criminal activity costs is driven by the relatively high societal cost per criminal offense, notably for violent crimes, such as aggravated assault and rape/sexual assault. Accepting the economic rationale for increased investment in SUD interventions will require recognizing that more benefits accrue to individuals by avoiding being victims of a crime than to governments through budget offsets resulting from savings in non-SUD program expenses. Future studies should explore individually tailored interventions to optimize care management, which may yield unexpected economic benefits to services utilization, and criminal activity data to estimate economic benefits across a broad range of interventions.
The greatest economic benefits over one year resulted from a reduction in criminal activity.
Alcohol use disorder interventions were associated with a decrease in healthcare utilization costs.
Reduced productivity following intervention was generally due to reduced labor force participation and lost earnings.
|Domaine :||Plusieurs produits / Several products|
|Sous-type de document :||Revue de la littérature / Literature review|
Department of Public Health Sciences, Division of Health Services Research and Policy, University of Miami-Miller School of Medicine, USA
Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA