The Cost-Effectiveness of Expanding Harm Reduction Activities for Injecting Drug Users in Odessa, Ukraine

Vickerman, Peter; Kumaranayake, Lilani; Balakireva, O. M.; Guinness, Lorna; Artyukh, Oksana; Semikop, Tatiana; Yaremenko, Olexander; Watts, Charlotte

doi:10.1097/01.olq.0000221335.80508.fa

Cited by 52 publications

(51 citation statements)

References 34 publications

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“…NSPs have been shown to be safe and effective in reducing HIV transmission in diverse settings (Bastos & Strathdee, 2000;Jenkins et al, 2001;Kwon et al, 2009;Vickerman et al, 2006;Wodak, 2006). A recent review of reviews found sufficient evidence of NSPs to reduce self-reported risky injecting behavior and tentative evidence of effectiveness of NSPs to reduce HIV transmission (Palmateer et al, 2010).…”

Section: Effectiveness and Cost-effectiveness Of Nspsmentioning

confidence: 99%

The cost-effectiveness of harm reduction

Wilson¹,

Donald²,

Shattock³

et al. 2015

International Journal of Drug Policy

129

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HIV prevalence worldwide among people who inject drugs (PWID) is around 19%. Harm reduction for PWID includes needle-syringe programs (NSPs) and opioid substitution therapy (OST) but often coupled with antiretroviral therapy (ART) for people living with HIV. Numerous studies have examined the effectiveness of each harm reduction strategy. This commentary discusses the evidence of effectiveness of the packages of harm reduction services and their cost-effectiveness with respect to HIV-related outcomes as well as estimate resources required to meet global and regional coverage targets. NSPs have been shown to be safe and very effective in reducing HIV transmission in diverse settings; there are many historical and very recent examples in diverse settings where the absence of, or reduction in, NSPs have resulted in exploding HIV epidemics compared to controlled epidemics with NSP implementation. NSPs are relatively inexpensive to implement and highly cost-effective according to commonly used willingness-to-pay thresholds. There is strong evidence that substitution therapy is effective, reducing the risk of HIV acquisition by 54% on average among PWID. OST is relatively expensive to implement when only HIV outcomes are considered; other societal benefits substantially improve the cost-effectiveness ratios to be highly favourable. Many studies have shown that ART is cost-effective for keeping people alive but there is only weak supportive, but growing evidence, of the additional effectiveness and cost-effectiveness of ART as prevention among PWID. Packages of combined harm reduction approaches are highly likely to be more effective and cost-effective than partial approaches. The coverage of harm reduction programs remains extremely low across the world. The total annual costs of scaling up each of the harm reduction strategies from current coverage levels, by region, to meet WHO guideline coverage targets are high with ART greatest, followed by OST and then NSPs. But scale-up of all three approaches is essential. These interventions can be cost-effective by most thresholds in the short-term and cost-saving in the long-term.

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Section: Effectiveness and Cost-effectiveness Of Nspsmentioning

confidence: 99%

The cost-effectiveness of harm reduction

Wilson¹,

Donald²,

Shattock³

et al. 2015

International Journal of Drug Policy

129

View full text Add to dashboard Cite

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“…Other biological parameters such as risk of HIV transmission per injection with a shared injection (β), and effectiveness of syringe cleaning to prevent virus transmission (ε) were obtained from literature (22)(23)(24)(25)(26)(27)(28)(29)(30). A summary of such parameters for each group, with and without sufficient NSP coverage, is presented in Table 1.…”

Section: Model's Parametersmentioning

confidence: 99%

Impact of Needle and Syringe Program Coverage on HIV Incidence in People Who Inject Drugs

Noroozi

Mirzazadeh

et al. 2016

Int J High Risk Behav Addict

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“…However, transmission of HIV is found largely due to sharing of syringes among drug users and practicing unsafe sex. The activities involved promotion of safe drug use practices and sexual behavior through provision of condoms, syringes and information materials [11]. Apart from preventing the spread of HIV, harm reduction strategies also aim to raise awareness and provide education within the IDU community about HIV and other diseases [12].…”

Section: Harm Reductionmentioning

confidence: 99%

“…These work mostly involved classifying and quantifying the costs of harm reduction, as evident by some literatures. Any costs that relates to detecting and treating of diseases were classified as direct costs whereas costs that relates to any production lost as a result of premature mortality, morbidity and the use of health care services were classified as indirect costs [1].The intervention costs have also been classified as financial costs and economic costs [2]. In measuring the effectiveness of the activities, productivity costs were also introduced which described some indirect costs associated to intervention activities [3].…”

Section: Introductionmentioning

confidence: 99%

Applying Total Quality Management Cost Model in Drug Intervention Programme

Hamid¹,

Omar²,

Sulaiman³

et al. 2015

JOEBM

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Abstract-Total Quality Management has been applied widely in the business sector in particular to assess the impact of continuous quality in the day to day operation. The emphasis was more on preventive than cure. Many government sectors in Malaysia are moving towards adopting this concept to ensure that quality product and services are delivered to their customers. In this paper, the researcher introduces the concept of TQM to cost drug intervention programme in particular the Needle and Syringe Exchange Programme (NSEP), conducted in Kota Bharu, Kelantan, Malaysia. The paper also measures the effectiveness of the activities using the concept of 4Cs. The framework has never been used before to cost and at the same time determine the effectiveness of harm reduction programme. The result demonstrated that the NSEP is cost effective in preventing the spreading of HIV virus through needle-syringe sharing. It also reveals the importance of creating awareness among the public about the programme and the benefits of such programme. The research findings will better promote the programme to the government so that a larger investment would be made to prevent the spreading of HIV virus in the country.Index terms-4Cs, harm reduction, NSEP, total quality management. I. INTRODUCTIONIn the past, cost effectiveness on the harm reduction programmes were conducted through the eyes of non-management accountant. These work mostly involved classifying and quantifying the costs of harm reduction, as evident by some literatures. Any costs that relates to detecting and treating of diseases were classified as direct costs whereas costs that relates to any production lost as a result of premature mortality, morbidity and the use of health care services were classified as indirect costs [1].The intervention costs have also been classified as financial costs and economic costs [2]. In measuring the effectiveness of the activities, productivity costs were also introduced which described some indirect costs associated to intervention activities [3]. The harm reduction has also been identified as annual costs of methadone substitution; additional counselling and program support costs as well as annual health costs [4].In this paper the authors will costs the activities relating to harm reduction using the total quality management by introducing the 4Cs. Manuscript

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The Cost-Effectiveness of Expanding Harm Reduction Activities for Injecting Drug Users in Odessa, Ukraine

Abstract: At the current coverage, the harm reduction intervention in Odessa is cost-effective but is unlikely to reduce IDU HIV prevalence in the short-term. To reduce HIV prevalence, more resources are needed to increase coverage.

Cited by 52 publications

References 34 publications

The cost-effectiveness of harm reduction

The cost-effectiveness of harm reduction

Impact of Needle and Syringe Program Coverage on HIV Incidence in People Who Inject Drugs

Applying Total Quality Management Cost Model in Drug Intervention Programme

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