Evidence map›Paper›PMID 36638680›Full record

Trial reportDrug and alcohol dependence2023

Cost and cost-effectiveness of abstinence contingent wage supplements.

Stephen Orme, Gary A Zarkin, Jackson Luckey, Laura J Dunlap, Matthew D Novak, August F Holtyn, Forrest Toegel, Kenneth Silverman

Erratum issuedAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Stephen OrmeRTI International, Research Triangle Park, NC, United States. Electronic address: sorme@rti.org.
Gary A ZarkinRTI International, Research Triangle Park, NC, United States.
Jackson LuckeyRTI International, Research Triangle Park, NC, United States.
Laura J DunlapRTI International, Research Triangle Park, NC, United States.
Matthew D NovakJohns Hopkins University School of Medicine, Baltimore, MD, United States.
August F HoltynJohns Hopkins University School of Medicine, Baltimore, MD, United States.
Forrest ToegelJohns Hopkins University School of Medicine, Baltimore, MD, United States.
Kenneth SilvermanJohns Hopkins University School of Medicine, Baltimore, MD, United States.

Funding

HUMAN BEHAVIORAL PHARMACOLOGY OF SUBSTANCE ABUSET32DA007209 · NIDA · JOHNS HOPKINS UNIVERSITY · PI Eric C. Strain, Elise M Weerts · 1985 to 2026
$12.9M
Abstinence-Contingent Wage Supplements for Long-Term Treatment of Drug AddictionR01DA037314 · NIDA · JOHNS HOPKINS UNIVERSITY · PI SILVERMAN, KENNETH · 2015 to 2019
$3.4M
NIDA NIH HHS R01 DA037314NIDA NIH HHS T32 DA007209
6 · The paper itself

Abstract

backgroundSubstance use disorders are correlated with unemployment and poverty. However, few interventions aim to improve substance use, unemployment, and, distally, poverty. The Abstinence-Contingent Wage Supplement (ACWS) randomized controlled trial combined a therapeutic workplace with abstinence-contingent wage supplements to address substance use and unemployment. The ACWS study found that abstinence-contingent wage supplements increased the percentage of participants who had negative drug tests, who were employed, and who were above the poverty line during the intervention period. This study presents the cost of ACWS and calculates the cost-effectiveness of ACWS compared with usual care.

methodsTo calculate the cost and cost-effectiveness of ACWS, we used activity-based costing methods to cost the intervention and calculated the costs from the provider and healthcare sector perspective. We calculated incremental cost-effectiveness ratios and cost-effectiveness acceptability curves for negative drug tests and employment.

resultsACWS cost $11,310 per participant over the 12-month intervention period. Total intervention and healthcare costs per participant over the intervention period were $20,625 for usual care and $30,686 for ACWS. At the end of the intervention period an additional participant with a negative drug test cost $1437 while an additional participant employed cost $915.

conclusionsACWS increases drug abstinence and employment and may be cost-effective at the end of the 12-month intervention period if decision makers are willing to pay the incremental cost associated with the intervention.

Indexed as

Substance-Related DisordersCost-Benefit AnalysisHumansSalaries and Fringe BenefitsSubstance Abuse DetectionWorkplaceCocaineContingency managementCost-effectivenessEmploymentOpioidsTherapeutic workplace

Identifiers

PMID36638680
PMCPMC10207811

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Registered trials

None linked

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.