Cost Effectiveness of Streetworks’ Needle Exchange Program of Edmonton

Subst Abuse Treat Prev Policy

Reid

Andresen

2013

BackgroundThis paper will determine whether expanding Insite (North America’s first and only supervised injection facility) to more locations in Canada such as Montreal, cost less than the health care consequences of not having such expanded programs for injection drug users.MethodsBy analyzing secondary data gathered in 2012, this paper relies on mathematical models to estimate the number of new HIV and Hepatitis C (HCV) infections prevented as a result of additional SIF locations in Montreal.ResultsWith very conservative estimates, it is predicted that the addition of each supervised injection facility (up-to a maximum of three) in Montreal will on average prevent 11 cases of HIV and 65 cases of HCV each year. As a result, there is a net cost saving of CDN$0.686 million (HIV) and CDN$0.8 million (HCV) for each additional supervised injection site each year. This translates into a net average benefit-cost ratio of 1.21: 1 for both HIV and HCV.ConclusionsFunding supervised injection facilities in Montreal appears to be an efficient and effective use of financial resources in the public health domain.

Section: Methodsmentioning

confidence: 99%

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Montreal, Canada

Subst Abuse Treat Prev Policy

Reid

Andresen

2013

“…As with the Jacobs et al [31] mathematical model, the values for these parameters (and their sources) are shown in Table 2. And the rate of needle sharing variable is manipulated in the same manner.…”

Section: Introductionmentioning

confidence: 99%

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada

Subst Abuse Treat Prev Policy

Reid

Andresen

et al. 2014

BackgroundSupervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada’s capital city, Ottawa.MethodsThe current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed.ResultsThe sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases – when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent.ConclusionsFunded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain.

“…Rather, it employed static mathematical models that only consider the reduction in HIV and HCV cases linearly. Such models are typically used to evaluate needle exchange programs [24, 34]. …”

Section: Discussionmentioning

confidence: 99%

“…For the current analysis, it was necessary to rely on a model that could reflect the effects of providing clean equipment and adopting safer injection behaviors in its calculations. Drawing from the methodology of research on the economic impact of a needle exchange program in Edmonton, the current study uses a mathematical model to estimate the number of HCV and HIV infections that could be prevented through the establishment of an SIF [24]. The number of new HIV/HCV infections avoided, (A), is calculated as follows: …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Exploring the role of an unsanctioned, supervised peer driven injection facility in reducing HIV and hepatitis C infections in people that require assistance during injection

2015

Health Justice

BackgroundSupervised consumption rooms or supervised injection facilities (SIFs) are venues that have reduced the risk of needle sharing and deaths caused by drug overdose among people who inject drugs (PWID). As a result of such a decline in the mortality rate, numerous studies have been able to illustrate its cost-effectiveness. However, studies have neglected to examine the same phenomena for unsanctioned SIFs that are run by peer drug users and provide assisted injections.MethodsThe current study will determine whether the former unsanctioned SIF, that provided assisted injection and was operated by the grass root organization called Vancouver Area Network of Drug Users (VANDU), cost less than the health care consequences of not having such a program in Vancouver, Canada. By analyzing data gathered in 2013, this paper relies on two mathematical models to estimate the number of new HIV and HCV infections prevented by the former unsanctioned facility in Vancouver’s Downtown Eastside.ResultsA conservative estimate indicates that the SIF location that provided assisted injections has a benefit-cost ratio of 33.1:1 due to its low operational cost. At the baseline sharing rate, the facility, on an average, reduced 81 HCV and 30 HIV cases among PWID each year. Such reductions in blood borne infections among PWID resulted in annual savings worth CAN$4.3 million dollars in health care expenditure. In addition to this, the current paper relies on a sensitivity analysis based on different needle sharing rate scenarios.ConclusionsThe sensitivity analysis and the baseline rates indicate that funding SIF facilities operated by peer drug users that facilitate assisted injection appear to be an efficient and effective use of financial resources in the public health domain since they lead to a significant decline in the rate of mortality within a vulnerable population.