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Cost Effectiveness and Resource Allocation

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Open Access 01-12-2014 | Research

Comparing the cost effectiveness of harm reduction strategies: a case study of the Ukraine

Authors: Sung Wook Kim, Anni-Maria Pulkki-Brannstrom, Jolene Skordis-Worrall

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2014

Abstract

Background

Harm reduction strategies commonly include needle and syringe programmes (NSP), opioid substitution therapy (OST) and interventions combining these two strategies. Despite the proven effectiveness of harm-reduction strategies in reducing human immunodeficiency virus (HIV) infection among injecting drug users (IDUs), no study has compared the cost-effectiveness of these interventions, nor the incremental cost effectiveness of combined therapy. Using data from the Global Fund, this study compares the cost-effectiveness of harm reduction strategies in Eastern Europe and Central Asia, using the Ukraine as a case study.

Methods

A Markov Monte Carlo simulation is carried out using parameters from the literature and cost data from the Global Fund. Effectiveness is presented as both QALYs and infections averted. Costs are measured in 2011 US dollars.

Results

The Markov Monte Carlo simulation estimates the cost-effectiveness ratio per infection averted as $487.4 [95% CI: 488.47-486.35] in NSP and $1145.9 [95% CI: 1143.39-1148.43] in OST. Combined intervention is more costly but more effective than the alternative strategies with a cost effectiveness ratio of $851.6[95% CI: 849.82-853.55].

The ICER of the combined strategy is $1086.9/QALY [95% CI: 1077.76:1096.24] compared with NSP, and $461.0/infection averted [95% CI: 452.98:469.04] compared with OST. These results are consistent with previous studies.

Conclusions

Despite the inherent limitations of retrospective data, this study provides evidence that harm-reduction interventions are a cost-effective way to reduce HIV prevalence. More research on into cost effectiveness in different settings, and the availability of fiscal space for government uptake of programmes, is required.

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Title: Comparing the cost effectiveness of harm reduction strategies: a case study of the Ukraine
Authors: Sung Wook Kim
Anni-Maria Pulkki-Brannstrom
Jolene Skordis-Worrall
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Cost Effectiveness and Resource Allocation / Issue 1/2014
Electronic ISSN: 1478-7547
DOI: https://doi.org/10.1186/1478-7547-12-25

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparing the cost effectiveness of harm reduction strategies: a case study of the Ukraine

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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