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Corrigendum to “Cost and cost-effectiveness of interim methadone treatment and patient navigation initiated in jail
[Drug Alcohol Depend. 217 (2020) 108292]
Zarkin, G. A., Orme, S., Dunlap, L. J., Kelly, S. M., Mitchell, S. G., O'Grady, K. E., & Schwartz, R. P. (2024). Corrigendum to “Cost and cost-effectiveness of interim methadone treatment and patient navigation initiated in jail: [Drug Alcohol Depend. 217 (2020) 108292]. Drug and Alcohol Dependence, 254, Article 110913. https://doi.org/10.1016/j.drugalcdep.2020.108292, https://doi.org/10.1016/j.drugalcdep.2023.110913
BACKGROUND: Individuals with opioid use disorder (OUD) who are released from pre-trial detention in jail have a high risk of opioid relapse. While several interventions for OUD initiated during incarceration have been studied, few have had an economic evaluation. As part of a three-group randomized trial, we estimated the cost and cost-effectiveness of a negative urine opioid test. Detainees were assigned to interim methadone (IM) in jail with continued methadone treatment post-release with and without 3 months of post-release patient navigation (PN) compared to an enhanced treatment-as-usual group.
METHODS: We implemented a micro-costing approach from the provider's perspective to estimate the cost per participant in jail and over the 12 months post-release from jail. Economic data included jail-based and community-based service utilization, self-reported healthcare utilization and justice system involvement, and administrative arrest records. Our outcome measure is the number of participants with a negative opioid urine test at their 12-month follow-up. We calculated incremental cost-effectiveness ratios (ICERs) for intervention costs only and costs from a societal perspective.
RESULTS: The average cost of providing patient navigation services per individual beginning in jail and continuing in the community was $283. We find that IM is dominated by ETAU and IM + PN. Per additional participant with a negative opioid urine test, the ICER for IM + PN including intervention costs only is $91 and $305 including societal costs.
CONCLUSIONS: IM + PN is almost certainly the cost-effective choice from both an intervention provider and societal perspective.