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An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence

AIMS: To determine whether the provision of contingency management using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost‐effective use of health‐care resources. DESIGN: A probabilistic cost‐effectiveness analysi...

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Autores principales: Rafia, Rachid, Dodd, Peter J., Brennan, Alan, Meier, Petra S., Hope, Vivian D., Ncube, Fortune, Byford, Sarah, Tie, Hiong, Metrebian, Nicola, Hellier, Jennifer, Weaver, Tim, Strang, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347913/
https://www.ncbi.nlm.nih.gov/pubmed/26990598
http://dx.doi.org/10.1111/add.13385
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author Rafia, Rachid
Dodd, Peter J.
Brennan, Alan
Meier, Petra S.
Hope, Vivian D.
Ncube, Fortune
Byford, Sarah
Tie, Hiong
Metrebian, Nicola
Hellier, Jennifer
Weaver, Tim
Strang, John
author_facet Rafia, Rachid
Dodd, Peter J.
Brennan, Alan
Meier, Petra S.
Hope, Vivian D.
Ncube, Fortune
Byford, Sarah
Tie, Hiong
Metrebian, Nicola
Hellier, Jennifer
Weaver, Tim
Strang, John
author_sort Rafia, Rachid
collection PubMed
description AIMS: To determine whether the provision of contingency management using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost‐effective use of health‐care resources. DESIGN: A probabilistic cost‐effectiveness analysis was conducted, using a decision‐tree to estimate the short‐term clinical and health‐care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long‐term clinical consequences and costs associated with hepatitis B infection. SETTINGS AND PARTICIPANTS: Data on attendance to vaccination from a UK cluster randomized trial. INTERVENTION: Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives. MEASUREMENT: Life‐time health‐care costs and quality‐adjusted life years discounted at 3.5% annually; incremental cost‐effectiveness ratios. FINDINGS: The resulting estimate for the incremental life‐time health‐care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = –£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8–30). The probabilistic incremental cost per quality adjusted life‐year gained of the contingency management programme was estimated to be £6738 (95% CI = £6297–7172), with an 89% probability of being considered cost‐effective at a threshold of £20 000 per quality‐adjusted life years gained (97.60% at £30 000). CONCLUSIONS: Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost‐effective use of health‐care resources in the UK as long as the incidence remains above 1.2%.
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spelling pubmed-53479132017-03-23 An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence Rafia, Rachid Dodd, Peter J. Brennan, Alan Meier, Petra S. Hope, Vivian D. Ncube, Fortune Byford, Sarah Tie, Hiong Metrebian, Nicola Hellier, Jennifer Weaver, Tim Strang, John Addiction Research Reports AIMS: To determine whether the provision of contingency management using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost‐effective use of health‐care resources. DESIGN: A probabilistic cost‐effectiveness analysis was conducted, using a decision‐tree to estimate the short‐term clinical and health‐care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long‐term clinical consequences and costs associated with hepatitis B infection. SETTINGS AND PARTICIPANTS: Data on attendance to vaccination from a UK cluster randomized trial. INTERVENTION: Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives. MEASUREMENT: Life‐time health‐care costs and quality‐adjusted life years discounted at 3.5% annually; incremental cost‐effectiveness ratios. FINDINGS: The resulting estimate for the incremental life‐time health‐care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = –£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8–30). The probabilistic incremental cost per quality adjusted life‐year gained of the contingency management programme was estimated to be £6738 (95% CI = £6297–7172), with an 89% probability of being considered cost‐effective at a threshold of £20 000 per quality‐adjusted life years gained (97.60% at £30 000). CONCLUSIONS: Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost‐effective use of health‐care resources in the UK as long as the incidence remains above 1.2%. John Wiley and Sons Inc. 2016-05-06 2016-09 /pmc/articles/PMC5347913/ /pubmed/26990598 http://dx.doi.org/10.1111/add.13385 Text en © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Research Reports
Rafia, Rachid
Dodd, Peter J.
Brennan, Alan
Meier, Petra S.
Hope, Vivian D.
Ncube, Fortune
Byford, Sarah
Tie, Hiong
Metrebian, Nicola
Hellier, Jennifer
Weaver, Tim
Strang, John
An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title_full An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title_fullStr An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title_full_unstemmed An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title_short An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
title_sort economic evaluation of contingency management for completion of hepatitis b vaccination in those on treatment for opiate dependence
topic Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347913/
https://www.ncbi.nlm.nih.gov/pubmed/26990598
http://dx.doi.org/10.1111/add.13385
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