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Economic Evaluation of  Substance Abuse Treatments: Aspects, Implications, Challenges Gerasimos Papanastasatos , PhD and Petros Triantos MSc KETHEA  Research  D epartment   Therapy Center For Dependent Individuals (KETHEA) Athens, GREECE
Evaluation: a meaning to define  ,[object Object],[object Object],[object Object],[object Object],( Patton, 1997; WHO, 2000;DHHS, 2005)
Systematic evaluation of substance abuse program includes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Basic assumptions ,[object Object],[object Object],[object Object],[object Object],(Aneurin Bevin, 1948)
Evaluation: Common views ,[object Object],[object Object],[object Object],[object Object],“ Flossing Your teeth”  (You hate to do it but you know it should be done) “ Doing your taxes when you know you won’t get a refund”  (Something to post off until the last possible moment) “ Doing a stage performance and having your clothes fall off”  (Submitting to the risk of public exposure)
The skepticism even with good intentions  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pragmatist –and maybe distressing – answers  ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The necessity for economic evaluation  institutional context
[object Object],[object Object],[object Object],[object Object],The necessity for economic evaluation fuctional persuasiveness
Defining economic evaluation ,[object Object],Drummond et. al, 1987
Two big questions remain open  ,[object Object],[object Object]
Drug Abuse Treatment  Core  Components and  Comprehensive  Services Medical Mental Health Vocational Educational Legal AIDS / HIV Risks Financial Housing &  Transportation Child Care Family Etheridge, Hubbard, Anderson, Craddock, & Flynn, 1997 ( PAB ) core treatment  Continuing Care Case Management Urine Monitoring Self-Help (AA/NA) Pharmaco-therapy Group/Individual Counseling Abstinence Based Intake  Assessment Treatment  Plans
What does Economic Evaluation Involve? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Measuring Costs ,[object Object],[object Object],[object Object]
Measuring Costs:  defining opportunity cost ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of economic evaluation Cost-Effectiveness Mostly used until 1980 in medicine. It is based in the comparison between cost and ONE effectiveness index   ( i.e. life years gained as a result of a treatment ) Cost-Utility Similar to Cost-effectiveness focus is on only one effectiveness index. Introducing the quality factor  ( i.e. quality life years gained /QALY as a result of a treatment) Cost- Benefit Conversion of selected effectiveness indexes into monetary units and comparison to opportunity cost for the operation of a treatment setting.
[object Object],[object Object],[object Object],Research Experience (restrains)
[object Object],[object Object],[object Object],[object Object],[object Object],Research Experience (steps done)
Economic Evaluation: literature Review in US therapeutic programs ,[object Object],[object Object],[object Object],(Mc Allister &French, 2002)
[object Object],[object Object],[object Object],[object Object],[object Object],Methodology  (cost monitoring – logistic phase)
Methodology  (effectiveness measurement) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methodology (economization)
Methodology  (analogistic phase) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Procedures’ stages summary logistic  outcome  economization analogistic  DATCAP ASI / EuropASI Translation in monetary units Conclusions
Cost Analysis Tool: DATCAP  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(French 2001a, 2001b, www.DATCAP.com)
Effectiveness Analysis Tool: ASI and EuropASI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(McLellan, Kushner, Metzger, et al.1992; McLellan et al.1980)
[object Object],[object Object],[object Object],The skepticism continues  Critics on Economic Evaluation Methodology (Mc Allister &French, 2002)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Subjects for further examination  ( Reuter 1999, French, Salome et al. 2000 )

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Presentatie 2e Ronde Africa Do.

  • 1. Economic Evaluation of Substance Abuse Treatments: Aspects, Implications, Challenges Gerasimos Papanastasatos , PhD and Petros Triantos MSc KETHEA Research D epartment Therapy Center For Dependent Individuals (KETHEA) Athens, GREECE
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  • 12. Drug Abuse Treatment Core Components and Comprehensive Services Medical Mental Health Vocational Educational Legal AIDS / HIV Risks Financial Housing & Transportation Child Care Family Etheridge, Hubbard, Anderson, Craddock, & Flynn, 1997 ( PAB ) core treatment Continuing Care Case Management Urine Monitoring Self-Help (AA/NA) Pharmaco-therapy Group/Individual Counseling Abstinence Based Intake Assessment Treatment Plans
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  • 16. Types of economic evaluation Cost-Effectiveness Mostly used until 1980 in medicine. It is based in the comparison between cost and ONE effectiveness index ( i.e. life years gained as a result of a treatment ) Cost-Utility Similar to Cost-effectiveness focus is on only one effectiveness index. Introducing the quality factor ( i.e. quality life years gained /QALY as a result of a treatment) Cost- Benefit Conversion of selected effectiveness indexes into monetary units and comparison to opportunity cost for the operation of a treatment setting.
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  • 24. Procedures’ stages summary logistic outcome economization analogistic DATCAP ASI / EuropASI Translation in monetary units Conclusions
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