Evidence map›Paper›PMID 39299504›Full record

ArticleJournal of substance use and addiction treatment2024

An economic analysis of the cost of mobile units for harm reduction, naloxone distribution, and medications for opioid use disorder.

Mathieu Castry, Yjuliana Tin, Noah M Feder, Nikki Lewis, Avik Chatterjee, Maria Rudorf, Jeffrey H Samet, Donna Beers, Bethany Medley, Louisa Gilbert and 2 more

Abstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Mathieu CastryBoston Medical Center, Section of Infectious Diseases, United States of America.
Yjuliana TinUniversity of Colorado School of Medicine, Divisions of General Internal Medicine and Infectious Diseases, United States of America.
Noah M FederUniversity of Pittsburgh School of Medicine, United States of America.
Nikki LewisBoston Medical Center, Section of General Internal Medicine, United States of America.
Avik ChatterjeeBoston Medical Center, Section of General Internal Medicine, United States of America; Boston University Chobanian and Avedisian School of Medicine, United States of America.
Maria RudorfBoston Medical Center, Section of General Internal Medicine, United States of America.
Jeffrey H SametBoston Medical Center, Section of General Internal Medicine, United States of America; Boston University Chobanian and Avedisian School of Medicine, United States of America.
Donna BeersBoston Medical Center, Section of General Internal Medicine, United States of America.
Bethany MedleyColumbia University School of Social Work, Social Intervention Group, United States of America.
Louisa GilbertColumbia University School of Social Work, Social Intervention Group, United States of America.
Benjamin P LinasBoston Medical Center, Section of Infectious Diseases, United States of America; Boston University Chobanian and Avedisian School of Medicine, United States of America.
Joshua A BarocasUniversity of Colorado School of Medicine, Divisions of General Internal Medicine and Infectious Diseases, United States of America. Electronic address: Joshua.Barocas@CUAnschutz.edu.

Funding

MassHEAL - Reducing overdose deaths by 40% (2019-2023)UM1DA049412 · NIDA · BOSTON MEDICAL CENTER · PI SAMET, JEFFREY H. · 2019 to 2023
$82.9M
Kentucky CAN HEAL (Communities and Networks Helping End Addiction Long-term)UM1DA049406 · NIDA · UNIVERSITY OF KENTUCKY · PI WALSH, SHARON L. · 2019 to 2022
$81.7M
CHASE: An Innovative County-Level Public Health Response to the Opioid Epidemic in New York StateUM1DA049415 · NIDA · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI EL-BASSEL, NABILA, GILBERT, LOUISA · 2019 to 2023
$77.3M
Optimizing HEALing in Ohio Communities (OHiO)-Health Equity SupplementUM1DA049417 · NIDA · OHIO STATE UNIVERSITY · PI FREISTHLER, BRIDGET J, WINHUSEN, T JOHN · 2019 to 2023
$66.3M
HEALing Communities Study Health Equity ResearchUM1DA049394 · NIDA · RESEARCH TRIANGLE INSTITUTE · PI GLASGOW, LASHAWN, KNOTT, CHARLES · 2019 to 2023
$40.6M
Training Program on HIV and Substance Use in the Criminal Justice SystemT32DA037801 · NIDA · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Nabila El-Bassel, Lisa R Metsch · 2014 to 2026
$5.7M
Development of a novel community-based high-performance surveillance network for drug useDP2DA051864 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BAROCAS, JOSHUA ADAM · 2020 to 2020
$2.3M
Strategies to reduce serious bacterial infections and overdose among people who inject drugsK01DA051684 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BAROCAS, JOSHUA ADAM · 2020 to 2024
$809k
NIDA NIH HHS DP2 DA051864NIDA NIH HHS K01 DA051684NIDA NIH HHS T32 DA037801NIDA NIH HHS UM1 DA049394NIDA NIH HHS UM1 DA049406NIDA NIH HHS UM1 DA049412NIDA NIH HHS UM1 DA049415NIDA NIH HHS UM1 DA049417
6 · The paper itself

Abstract

BACKGROUND &

objectiveMobile substance use treatment units are effective approaches to increase treatment access and reduce barriers to opioid use disorder (OUD) care. However, little is known about the economic costs of maintaining and operating these units. This study aimed to estimate the economic costs of starting and maintaining mobile units providing harm reduction, overdose education and naloxone distribution (OEND), and medication for opioid use disorder (MOUD).

methodsAs part of the HEALing Communities Study, four communities in Massachusetts (Bourne/Sandwich, Brockton, Gloucester, Salem) implemented mobile units offering OEND and MOUD (buprenorphine and naltrexone only); each selected different services tailored to their community. All provided MOUD linkage via telehealth, but only one offered in-person MOUD prescribing on the unit. We retrospectively collected detailed resource utilization data from invoices to estimate the direct economic costs from August 2020 through June 2022. Cost components were categorized into start-up and operating costs. We calculated total economic cost over the study period and the average monthly operating cost.

resultsImplementing a mobile unit offering OEND and MOUD required a one-time median start-up cost of $59,762 (range: $52,062-$113,671), with 80 % of those costs attributed to the vehicle purchase. The median monthly operating cost was $14,464. The largest cost category for all mobile units was personnel costs. The monthly ongoing costs varied by community settings and services: approximately $5000 for two urban communities offering OEND and MOUD linkage via telehealth (Gloucester, Salem), $28,000 for a rural community (Bourne/Sandwich), and $23,000 for an urban community also providing in-person MOUD prescribing on the unit (Brockton).

conclusionThe economic costs of mobile substance use treatment and harm reduction units are substantial but vary by community settings and services offered. Our results provide valuable community-level economic data to stakeholders and policymakers considering establishing and/or expanding mobile units with OEND and MOUD services. Further exploration of cost-effectiveness and efficiency should be considered across different settings.

Indexed as

BuprenorphineHarm ReductionMobile Health UnitsNaloxoneNarcotic AntagonistsOpioid-Related DisordersDrug OverdoseHumansMassachusettsNaltrexoneOpiate Substitution TreatmentRetrospective StudiesTelemedicineBuprenorphineNaloxoneNaltrexoneNarcotic AntagonistsEconomic evaluationHarm reductionMedications for opioid use disorderMobile health unitsOpioid use disorder

Identifiers

PMID39299504
PMCPMC11527578

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Registered trials

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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.