Tran Anh Dam, Chen Rory, Sara Grant, McKetin Rebecca
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
NHMRC Clinical Trials Centre, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia.
Drug Alcohol Rev. 2025 May;44(4):1157-1168. doi: 10.1111/dar.14043. Epub 2025 Mar 20.
This study aims to estimate the drug treatment costs and health services utilisation costs among people who used different treatment modalities to treat methamphetamine dependence.
This is a sub-study of a prospective observational cohort study MATES (n = 501), including recruitment from 15 residential rehabilitation services, 13 counselling services and 11 detoxification units in Sydney and Brisbane, Australia. Participants with methamphetamine dependence who had used methamphetamine in the 28 days before baseline assessment and completed 3- and 12-month follow-ups were included (n = 323). Unit costs per day/episode of each treatment type were taken from published literature. Self-reported health services utilisation (HSU) was collected via structured face-to-face and telephone interviews. Hospital admissions were allocated a likely diagnosis grouping from the Australian Refined Diagnosis-Related Groupings. Emergency department presentations were allocated a likely triage category.
Average drug treatment costs per person per year were AU$10,540 (SD 13,995), accounting for 63% of total health-care costs, which were AU$16,862 (SD 19,908). Drug treatment costs of counselling participants were only around 40% of detox and residential rehab participants. However, the HSU costs of detox and rehab participants were approximately 60% lower than those of counselling participants.
Drug treatment costs accounted for more than half of total health care costs, representing a substantial financial burden. Detox and rehab treatment costs more but saved costs in health services use. HSU costs among people who had severe mental health problems and injected methamphetamine were substantially high. Strategies to support these groups are necessary to reduce the cost burden.
本研究旨在估算使用不同治疗方式治疗甲基苯丙胺成瘾者的药物治疗成本和卫生服务利用成本。
这是一项前瞻性观察队列研究MATES（n = 501）的子研究，研究对象招募自澳大利亚悉尼和布里斯班的15家住院康复服务机构、13家咨询服务机构和11家戒毒单位。纳入在基线评估前28天内使用过甲基苯丙胺且完成3个月和12个月随访的甲基苯丙胺成瘾者（n = 323）。每种治疗类型的每日/每次治疗单元成本取自已发表的文献。通过结构化面对面访谈和电话访谈收集自我报告的卫生服务利用情况（HSU）。医院入院病例根据澳大利亚精细诊断相关分组分配可能的诊断分组。急诊就诊病例分配可能的分诊类别。
每人每年的平均药物治疗成本为10,540澳元（标准差13,995），占总医疗保健成本16,862澳元（标准差19,908）的63%。接受咨询的参与者的药物治疗成本仅为戒毒和住院康复参与者的40%左右。然而，戒毒和康复参与者的卫生服务利用成本比接受咨询的参与者低约60%。
药物治疗成本占总医疗保健成本的一半以上，是一项沉重的经济负担。戒毒和康复治疗成本更高，但在卫生服务使用方面节省了成本。患有严重心理健康问题且注射甲基苯丙胺者的卫生服务利用成本非常高。有必要采取策略来支持这些群体，以减轻成本负担。
