Economic evaluations of contingency management in illicit drug misuse programmes: A systematic review

Shearer, James; Tie, Hiong; Byford, Sarah

doi:10.1111/dar.12240

Cited by 24 publications

(16 citation statements)

References 24 publications

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“…Only one study meeting the criteria for this review was included. [32] Shearer et al[26] conducted a systematic review of contingency management economic evaluations. Three of the studies identified by the authors targeted opioid use as one of the clinical outcomes, two of which met the inclusion criteria for this study.…”

Section: Resultsmentioning

confidence: 99%

“…A number of recent systematic reviews of economic evaluations for various opioid use disorder interventions were identified. [19-26] The most comprehensive review was performed by Doran[22] who included studies up to 2007. Given the quality of the Doran review, which is discussed below, we narrowed our search to focus on studies published since 2007.…”

Section: Review Methodsmentioning

confidence: 99%

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Economic Evaluations of Opioid Use Disorder Interventions

Murphy

Polsky

2016

PharmacoEconomics

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Background The economic costs associated with opioid misuse are immense. Effective interventions for opioid use disorders are available; however, given the scarce resources faced by substance-use treatment providers and payers of all kinds, evidence of effectiveness is not always sufficient to encourage the adoption of a given therapy, nor should it be. Economic evaluations can provide evidence that will help stakeholders efficiently allocate their resources. Objective The purpose of this study was to review the literature on economic evaluations of opioid use disorder interventions. Methods We performed a systematic review of the major electronic databases from inception until present (August 2015). A sensitive approach was used to ensure a comprehensive list of relevant articles. Given the quality of existing reviews, we narrowed our search to studies published since 2007. The Drummond checklist was used to evaluate and categorize economic-evaluation studies according to their quality. Results A total of 98 articles were identified as potentially relevant to the current study. Of these 98 articles, half (n=49) were included in this study. Six of the included articles were review in nature. The remaining 43 articles performed an economic evaluation of an intervention for opioid use disorders. In general, the evidence on methadone-maintenance therapy (MMT) supports previous findings that MMT is an economically advantageous opioid-use-disorder therapy. The economic literature comparing MMT to other opioid-use-disorder pharmacotherapies is limited, as is the literature on other forms of therapy. Conclusions With the possible exception of MMT, additional high-quality economic evaluations are needed in order to assess the relative value of existing opioid-use-disorder interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Review Methodsmentioning

confidence: 99%

Economic Evaluations of Opioid Use Disorder Interventions

Murphy

Polsky

2016

PharmacoEconomics

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“…Most importantly, cost-effectiveness should be the eventual arbiter in such matters, but is an area where CM and other treatment development research for SUDs is lacking. In a recent review on cost-effectiveness studies on use of CM with illicit drug use disorders, for example, only nine studies were identified (Shearer et al, 2015). While results were generally supportive, they were also deemed inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…One focused on CM involving a wide range of different types of incentives (Prendergast et al, 2006), another was limited to only CM studies that used a probabilistic schedule of incentive delivery (Benishek et al, 2014), still another on CM interventions implemented in outpatient methadone maintenance clinics (Griffith et al, 2000), and one that examined only CM studies that included a cost-effectiveness analysis (Shearer et al, 2015). However, none of those reviews duplicate the focus of the present systematic review on contributing to a series exclusively focused on the use of vouchers and related financial incentives among those with SUDs.…”

Section: Introductionmentioning

confidence: 99%

A review of the literature on contingency management in the treatment of substance use disorders, 2009–2014

Davis

Kurti

Skelly

et al. 2016

Preventive Medicine

208

147

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This report describes a systematic literature review of voucher and related monetary-based contingency management (CM) interventions for substance use disorders (SUDs) over 5.2 years (November 2009 through December 2014). Reports were identified using the search engine PubMed, expert consultations, and published bibliographies. For inclusion, reports had to (a) involve monetary-based CM; (b) appear in a peer-reviewed journal; (c) include an experimental comparison condition; (d) describe an original study; (e) assess efficacy using inferential statistics; (f) use a research design allowing treatment effects to be attributed to CM. Sixty-nine reports met inclusion criteria and were categorized into 7 research trends: (1) extending CM to special populations, (2) parametric studies, (3) extending CM to community clinics, (4) combining CM with pharmacotherapies, (5) incorporating technology into CM, (6) investigating longer-term outcomes, (7) using CM as a research tool. The vast majority (59/69, 86%) of studies reported significant (p < 0.05) during-treatment effects. Twenty-eight (28/59, 47%) of those studies included at least one follow-up visit after CM was discontinued, with eight (8/28, 29%) reporting significant (p < 0.05) effects. Average effect size (Cohen’s d) during treatment was 0.62 (95% CI: 0.54, 0.70) and post-treatment it was 0.26 (95% CI: 0.11, 0.41). Overall, the literature on voucher-based CM over the past 5 years documents sustained growth, high treatment efficacy, moderate to large effect sizes during treatment that weaken but remain evident following treatment termination, and breadth across a diverse set of SUDs, populations, and settings consistent with and extending results from prior reviews.

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“…Adolescents who attend their scheduled visits and/or have negative urine drug tests are provided monetary prizes or other rewards to reinforce their treatment plan adherence [9,31,32]. In many settings, the value of prizes increases incrementally with each successive attended visit or negative drug screen, which further improves the efficacy of treatment [31,33,34]. …”

Section: Indications For Drug Testingmentioning

confidence: 99%

Objective Testing

Hadland

Levy

2016

Child and Adolescent Psychiatric Clinics of North America

130

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Drug testing, when carefully collected and thoughtfully interpreted, offers a critical adjunct to clinical care and substance use treatment. However, because test results can be misleading if not interpreted in the correct clinical context, clinicians should always conduct a careful interview with adolescent patients to understand what testing is likely to show and then use testing to validate or refute their expectations. Due to the ease with which samples can be tampered, providers should also carefully reflect on their own collection protocols and sample validation procedures to ensure optimal accuracy.

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Economic evaluations of contingency management in illicit drug misuse programmes: A systematic review

Abstract: The data were not sufficiently strong to make any conclusion about the cost-effectiveness of CM. More relevant and comprehensive evidence for cost-effectiveness than currently exists is needed.

Cited by 24 publications

References 24 publications

Economic Evaluations of Opioid Use Disorder Interventions

Economic Evaluations of Opioid Use Disorder Interventions

A review of the literature on contingency management in the treatment of substance use disorders, 2009–2014

Objective Testing

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