SynthesisBMJ (Clinical research ed.)2005
Cost utility analysis of co-prescribed heroin compared with methadone maintenance treatment in heroin addicts in two randomised trials.
Synthesis in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 5 syntheses or guidelines pooled it, 156 citations in OpenAlex.
- Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.Journal of psychopharmacology (Oxford, England) · 2026Guideline
- Patterns of use and adverse events reported among persons who regularly inject buprenorphine: a systematic review.Harm reduction journal · 2022Pooled it
- Health-Related Resource-Use Measurement Instruments for Intersectoral Costs and Benefits in the Education and Criminal Justice Sectors.PharmacoEconomics · 2017Pooled it
- The estimation of utility weights in cost-utility analysis for mental disorders: a systematic review.PharmacoEconomics · 2013Pooled it
- Heroin maintenance for chronic heroin-dependent individuals.The Cochrane database of systematic reviews · 2011Pooled it
- Trial
- Challenges for the implementation of injectable opioid agonist treatment: a scoping review.Harm reduction journal · 2024Article
- [Challenges in the treatment of opioid dependence].Der Nervenarzt · 2024Review
- Evaluation of heroin-assisted treatment in Norway: protocol for a mixed methods study.BMC health services research · 2024Article
- Changes in daily dose in open-label compared to double-blind: The role of clients' expectations in injectable opioid agonist treatment.Addictive behaviors reports · 2023Article
- Opioid-related deaths in Kingston, Frontenac, Lennox and Addington in Ontario, Canada: the shadow epidemic.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2023Article
- Econometric Issues in Prospective Economic Evaluations Alongside Clinical Trials: Combining the Nonparametric Bootstrap With Methods That Address Missing Data.Epidemiologic reviews · 2022Review
- Exploring why patients in heroin-assisted treatment are getting incarcerated-a qualitative study.BMC psychiatry · 2022Article
- Switzerland's Dependence on a Diamorphine Monopoly.Frontiers in psychiatry · 2022Review
- New Approaches in Drug Dependence: Opioids.Current addiction reports · 2021Review
- Comparison of Treatment Options for Refractory Opioid Use Disorder in the United States and Canada: a Narrative Review.Journal of general internal medicine · 2020Review
- Opioid use and misuse: health impact, prevalence, correlates and interventions.Psychology & health · 2019Review
- Review
- Towards a 'smart' cost-benefit tool: using machine learning to predict the costs of criminal justice policy interventions.Crime science · 2018Article
- The costs of crime associated with stimulant use in a Canadian setting.Drug and alcohol dependence · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the cost utility of medical co-prescription of heroin compared with methadone maintenance treatment for chronic, treatment resistant heroin addicts.
designCost utility analysis of two pooled open label randomised controlled trials.
settingMethadone maintenance programmes in six cities in the Netherlands.
participants430 heroin addicts.
interventionsInhalable or injectable heroin prescribed over 12 months. Methadone (maximum 150 mg a day) plus heroin (maximum 1000 mg a day) compared with methadone alone (maximum 150 mg a day). Psychosocial treatment was offered throughout.
main outcome measuresOne year costs estimated from a societal perspective. Quality adjusted life years (QALYs) based on responses to the EuroQol EQ-5D at baseline and during the treatment period.
resultsCo-prescription of heroin was associated with 0.058 more QALYs per patient per year (95% confidence interval 0.016 to 0.099) and a mean saving of 12,793 euros (8793 pounds sterling, 16,122 dollars) (1083 to 25,229 euros) per patient per year. The higher programme costs (16 222 euros; lower 95% confidence limit 15,084 euros) were compensated for by lower costs of law enforcement (- 4129 euros; upper 95% confidence limit - 486 euros) and damage to victims of crime (- 25,374 euros; upper 95% confidence limit - 16,625 euros). The results were robust for the use of national EQ-5D tariffs and for the exclusion of the initial implementation costs of heroin treatment. Completion of treatment is essential; having participated in any abstinence treatment in the past is not.
conclusionsCo-prescription of heroin is cost effective compared with treatment with methadone alone for chronic, treatment resistant heroin addicts.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.