Warren Emma, Viney Rosalie, Shearer James, Shanahan Marian, Wodak Alex, Dolan Kate
Centre for Health Economics Research and Evaluation, CHERE, University of Technology, Sydney, Australia.
Drug Alcohol Depend. 2006 Sep 15;84(2):160-6. doi: 10.1016/j.drugalcdep.2006.01.010. Epub 2006 Feb 17.
Although methadone maintenance treatment in community settings is known to reduce heroin use, HIV infection and mortality among injecting drug users (IDU), little is known about prison methadone programs. One reason for this is the complexity of undertaking evaluations in the prison setting. This paper estimates the cost-effectiveness of the New South Wales (NSW) prison methadone program.
Information from the NSW prison methadone program was used to construct a model of the costs of the program. The information was combined with data from a randomised controlled trial of provision of prison methadone in NSW. The total program cost was estimated from the perspective of the treatment provider/funder. The cost per heroin free day, compared with no prison methadone, was estimated. Assumptions regarding resource use were tested through sensitivity analysis.
The annual cost of providing prison methadone in NSW was estimated to be 2.9 million Australian dollars (or 3,234 Australian dollars per inmate per year). The incremental cost effectiveness ratio is 38 Australian dollars per additional heroin free day.
From a treatment perspective, prison methadone is no more costly than community methadone, and provides benefits in terms of reduced heroin use in prisons, with associated reduction in morbidity and mortality.
尽管已知社区环境中的美沙酮维持治疗可减少海洛因使用、降低注射吸毒者（IDU）中的艾滋病毒感染率和死亡率，但对于监狱美沙酮项目却知之甚少。原因之一是在监狱环境中进行评估存在复杂性。本文评估了新南威尔士州（NSW）监狱美沙酮项目的成本效益。
利用新南威尔士州监狱美沙酮项目的信息构建该项目成本模型。该信息与新南威尔士州监狱美沙酮提供的随机对照试验数据相结合。从治疗提供者/资助者的角度估算了项目总成本。估算了与不提供监狱美沙酮相比，无海洛因日的成本。通过敏感性分析测试了关于资源使用的假设。
新南威尔士州提供监狱美沙酮的年度成本估计为290万澳元（或每名囚犯每年3234澳元）。增量成本效益比为每增加一个无海洛因日38澳元。
从治疗角度来看，监狱美沙酮的成本并不高于社区美沙酮，并且在减少监狱中的海洛因使用方面具有益处，同时相关的发病率和死亡率也会降低。
