Abstract
Economic evaluations in health care involve the identification, measurement, valuation, and then comparison of the costs (inputs) and outcomes of treatments or preventive activities. The aim was to analyze the cost-utility of six-month methadone maintenance treatment program in a Lithuanian primary health care setting. A prospective study design was used. All the information was obtained through the validated questionnaires at the baseline and 3- and 6-month follow-ups. WHOQOL-BREF was used to assess the quality of life; the costs were assessed using the DATCAP methodology from the perspective of a patient and outpatient clinic during follow-up period. A total of 102 opioid-dependent patients were recruited in the study; 512 follow-up patient-months were obtained. The methadone maintenance treatment has significantly improved physical, psychological, and environmental components of quality of life during follow-up. Total program costs were 61 288.87 EUR. Cost paid by a patient comprised about 31% of total program costs. Cost per quality-adjusted life-month (QALM) for physical domain was 2227.55 EUR; for psychological domain, 1879.50 EUR; for social domain, 5467.64 EUR; and for environmental domain, 4626.47 EUR. Costs per QALM and quality-adjusted life-year (QALY) for total quality of life in the maintenance program were 2864.00 EUR and 34 368.00 EUR, respectively. Our results showed that 6-month methadone maintenance program was effective in the terms of quality-of-life improvement. Methadone maintenance treatment program was less effective in terms of cost per QALY.
Highlights
Lithuania is one of the Baltic States, which reestablished independence from the Soviet Union in 1990
Our results showed that 6-month methadone maintenance program was effective in the terms of quality-of-life improvement
Methadone maintenance treatment program was less effective in terms of cost per QALY
Summary
Lithuania is one of the Baltic States, which reestablished independence from the Soviet Union in 1990. Methadone has been used as a successful pharmacologic intervention for the treatment of heroin dependence and acute and chronic pain. This treatment is effective in opiate addiction, reducing morbidity and mortality associated with heroin use. The costs and the consequences (positive and negative) of interventions should be compared in order to examine the effective use of the scarce resources. In health care, it involves the identification, measurement, valuation, and comparison of the costs (inputs) and outcomes of treatments or preventive activities [4]. It is attributed to methodology and instruments used in economic evaluations [5]
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