[Economic efficiency of methadone maintenance and factors affecting it]

Abstract

Methadone maintenance is effective in reducing injection drug use, needle sharing, and the overall mortality associated with opiate abuse. Scientific literature describes that efficiency of methadone maintenance program depends on many factors. Our analysis is based on description of economic research methods and on factors affecting economic efficiency of methadone maintenance.

Methods: Computerized Medline data base was searched by key words: "economic evaluation", "cost-effectiveness", "cost-utility", "methadone", "methadone dosage", "ancillary services", "treatment duration". Review and analysis.

Results: Methadone maintenance therapy has higher economic efficiency with 80-100 mg per day methadone dose. Doses lower than 40 mg per day are considered as inefficient. Some methadone programs limit treatment to 90 days or less, but such short treatment episodes are not likely to be cost-effective. Ancillary services are more cost-effective at the beginning of methadone maintenance program, than in the later stages of the program. Economic efficiency is higher when program involves more participants, than when more ancillary services are provided. CONCLUSIONS. Effectiveness of Methadone maintenance program affects methadone dosage policy, treatment duration and ancillary services.