French M T, Mauskopf J A, Teague J L, Roland E J
School of Medicine, University of Miami, FL 33136, USA.
Med Care. 1996 Sep;34(9):890-910. doi: 10.1097/00005650-199609000-00003.
People who abuse drugs suffer from a host of medical problems that impose costs on both the abusers and society as a whole. Drug-abuse treatment and other interventions can help alleviate these medical problems, leading to health status improvements for chronic drug users and reduced social costs. The authors' dual purpose here is to (1) propose a theoretically rigorous yet easy-to-apply methodology for estimating the health-related costs of drug abuse and (2) demonstrate the methodology by estimating the potential dollar value of avoiding adverse health consequences as a result of successful drug-abuse interventions.
The authors' proposed multiattribute quality-adjusted life year methodology for estimating the value of avoiding morbidity and mortality involves eight steps to be followed sequentially. The framework is based on developing a common unit of well-being (i.e., quality-adjusted life year) that can be applied to all types of health conditions. If all health states can be denominated in this common unit, then the process of valuation is straightforward and consistent across all types of illnesses and diseases. The methodology is relatively inexpensive to execute because the estimation procedures are not complicated technically and the data demands are modest. Also, this approach incorporates elements from several disciplines, including psychology, epidemiology, medicine, and economics. Finally, the proposed methodology is flexible enough to cover a wide range of illnesses and diseases so that consistent and comparable estimates can be generated.
The authors estimate the dollar value of avoiding acute hepatitis B, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hypertension, bacterial pneumonia, sexually transmitted diseases, and tuberculosis for a white male aged 32 years. The authors' results illustrate that estimated avoided morbidity values can vary significantly across the range of health consequences associated with drug abuse. At the upper end of the range, the value of avoiding only the morbidity associated with a single case of HIV/AIDS is approximately $157,811 for the period beginning with transmission of HIV, through late-stage HIV and AIDS, and ending just before death.
People who abuse drugs suffer from many medical problems in addition to their addiction. The proposed approach for estimating the dollar value of avoiding adverse health consequences provides policy analysts, evaluators, and researchers a method to calculate theoretically based benefit estimates for use in a benefit-cost analysis of drug-abuse interventions.
滥用药物的人患有一系列医疗问题，这给滥用者本人及整个社会都带来了成本。药物滥用治疗及其他干预措施有助于缓解这些医疗问题，从而改善慢性吸毒者的健康状况并降低社会成本。作者在此的双重目的是：（1）提出一种理论严谨且易于应用的方法来估算药物滥用与健康相关的成本；（2）通过估算成功的药物滥用干预措施避免不良健康后果的潜在美元价值来展示该方法。
作者提出的用于估算避免发病和死亡价值的多属性质量调整生命年方法包括依次遵循的八个步骤。该框架基于建立一个可应用于所有类型健康状况的通用福祉单位（即质量调整生命年）。如果所有健康状态都能用这个通用单位来衡量，那么估值过程就很简单，并且在所有类型的疾病中都是一致的。该方法执行起来成本相对较低，因为估算程序在技术上并不复杂，对数据的要求也不高。此外，这种方法融合了多个学科（包括心理学、流行病学、医学和经济学）的要素。最后，所提出的方法足够灵活，能够涵盖广泛的疾病，从而可以生成一致且可比的估算值。
作者估算了一名32岁白人男性避免感染急性乙型肝炎、人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）、高血压、细菌性肺炎、性传播疾病和结核病的美元价值。作者的结果表明，在与药物滥用相关的一系列健康后果中，估算的避免发病价值可能会有显著差异。在该范围的上限，仅避免与一例HIV/AIDS相关发病的价值，从HIV传播开始，经过晚期HIV和AIDS，到死亡前这段时间约为157,811美元。
滥用药物的人除了成瘾外还患有许多医疗问题。所提出的估算避免不良健康后果美元价值的方法为政策分析师、评估人员和研究人员提供了一种方法，用于计算基于理论的效益估算值，以用于药物滥用干预措施的效益成本分析。
