Yale School of Public Health and Yale School of Medicine, New Haven, CT 06520, USA.
Addict Behav. 2012 Jan;37(1):1-10. doi: 10.1016/j.addbeh.2011.07.042. Epub 2011 Aug 5.
Drug abuse and transmission of HIV during pregnancy are public health problems that adversely affect pregnant women, their children and surrounding communities. Programs that address this vulnerable population have the ability to be cost-effective due to resulting cost savings for mother, child and society. Economic evaluations of programs that address these issues are an important tool to better understand the costs of services and create sustainable healthcare systems. This study critically examined economic evaluations of drug abuse treatment and HIV prevention programs in pregnant women. A systematic review was conducted using the criteria recommended by the Panel on Cost-Effectiveness in Health and Medicine and the British Medical Journal (BMJ) checklist for economic evaluations. The search identified 6 economic studies assessing drug abuse treatment for pregnant women, and 12 economic studies assessing programs that focus on prevention of mother-to-child transmission (PMTCT) of HIV. Results show that many programs for drug abuse treatment and PMTCT among pregnant women are cost-effective or even cost-saving. This study identified several shortcomings in methodology and lack of standardization of current economic evaluations. Efforts to address methodological challenges will help make future studies more comparable and have more influence on policy makers, clinicians and the public.
药物滥用和 HIV 在怀孕期间的传播是影响孕妇、其子女和周边社区的公共卫生问题。针对这一弱势群体的项目具有成本效益，因为可以为母亲、儿童和社会节省成本。对解决这些问题的项目进行经济评估是更好地了解服务成本和创建可持续医疗保健系统的重要工具。本研究对针对孕妇的药物滥用治疗和 HIV 预防项目的经济评估进行了批判性审查。使用健康和医学成本效益小组以及英国医学杂志 (BMJ) 经济评估清单推荐的标准进行了系统评价。该搜索确定了 6 项评估孕妇药物滥用治疗的经济研究，以及 12 项评估专注于预防母婴传播 (PMTCT) 的经济研究。结果表明，许多针对孕妇药物滥用治疗和 PMTCT 的项目具有成本效益，甚至可以节省成本。本研究发现，目前的经济评估在方法学上存在一些缺陷，并且缺乏标准化。解决方法学挑战的努力将有助于使未来的研究更具可比性，并对决策者、临床医生和公众产生更大的影响。
