A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Montreal, Canada

Ehsan Jozaghi,Martin A Andresen,Andrew A Reid

doi:10.1186/1747-597x-8-25

Abstract

BackgroundThis paper will determine whether expanding Insite (North America’s first and only supervised injection facility) to more locations in Canada such as Montreal, cost less than the health care consequences of not having such expanded programs for injection drug users.MethodsBy analyzing secondary data gathered in 2012, this paper relies on mathematical models to estimate the number of new HIV and Hepatitis C (HCV) infections prevented as a result of additional SIF locations in Montreal.ResultsWith very conservative estimates, it is predicted that the addition of each supervised injection facility (up-to a maximum of three) in Montreal will on average prevent 11 cases of HIV and 65 cases of HCV each year. As a result, there is a net cost saving of CDN$0.686 million (HIV) and CDN$0.8 million (HCV) for each additional supervised injection site each year. This translates into a net average benefit-cost ratio of 1.21: 1 for both HIV and HCV.ConclusionsFunding supervised injection facilities in Montreal appears to be an efficient and effective use of financial resources in the public health domain.

Highlights

The spread of infectious diseases among injection drug users (IDUs) is a serious public health concern
In a recent systematic review and meta-analysis analyzing research studies from Western Europe, Asia, Latin America, Australasia, Eastern Europe, and North America it was found that acquired immunodeficiency syndrome (AIDS) and a number of other blood-borne diseases transmitted through shared needles and syringes are of the leading causes of death across 67 cohorts of IDUs [1]
The analyses demonstrated that while expanding Insite may lead to further cost savings, this result was dependant on behavioral changes in the IDU population [13]

Summary

Introduction

The spread of infectious diseases among injection drug users (IDUs) is a serious public health concern. In a recent systematic review and meta-analysis analyzing research studies from Western Europe, Asia, Latin America, Australasia, Eastern Europe, and North America it was found that acquired immunodeficiency syndrome (AIDS) and a number of other blood-borne diseases transmitted through shared needles and syringes are of the leading causes of death across 67 cohorts of IDUs [1]. The extent of these health concerns is troubling. This paper will determine whether expanding Insite (North America’s first and only supervised injection facility) to more locations in Canada such as Montreal, cost less than the health care consequences of not having such expanded programs for injection drug users

Methods

Results

Conclusion