PMH20 - BUDGETARY IMPACT OF TREATING OPIOID ADDICTION IN THE DANISH MUNICIPAL SETTING

Abstract

In Denmark, municipalities are responsible for providing opiate substitution treatment. There are around 13,000 injecting drug users in Denmark, although only 7,050 people received Opioid Agonist Therapy (OAT) in 2015. A budget impact model was created that considered both the costs to the municipalities as well as to the criminal justice system to estimate the budgetary impact of treating opioid addiction as well as having 50% of users outside the treatment system. Costs and outcomes were modelled over a one-year timeframe, in a population calculated based on the average size of a Danish municipality (n=55,000) and the prevalence of intravenous drug use in Denmark (0,23%). Direct treatment were based on published tariffs by third sector providers in the form of a daily rate charged to the municipality. Wider societal costs (additional healthcare, mental health, and criminal justice) were based on published analyses of Danish registry data. clinical parameters used in the model were: i. retention in treatment and ii. Proportion of urine samples which are free from illicit opioids (i.e. no ‘use on top’) from published clinical trial data. Total direct treatment costs to an average municipality were 2.19 mDKK for one year. Total healthcare costs were 5.5 mDKK (1.24 mDKK generated by patients in treatment). Costs associated with court decisions and imprisonment were 4.35 mDKK (1.66 mDKK from patients who had started treatment). If treatment access were increased by 10%, an average municipality, and its associated health care and criminal justice systems, would save approximately -219 kDKK, 146 kDKK and 150 kDKK respectively. Our model shows that savings generated by from addiction treatment far outweigh the cost of treatment itself. New treatment approaches, that address known treatment barriers, could generate substantial further savings. Further research is warranted to identify additional direct and indirect costs and savings in Denmark.