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Randomized Controlled Trial
. 2014 May:62:71-7.
doi: 10.1016/j.ypmed.2014.01.029. Epub 2014 Feb 9.

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial

D Max Crowley  1 , Damon E Jones  2 , Donna L Coffman  3 , Mark T Greenberg  2
Affiliations
Randomized Controlled Trial

Can we build an efficient response to the prescription drug abuse epidemic? Assessing the cost effectiveness of universal prevention in the PROSPER trial

D Max Crowley et al. Prev Med. 2014 May.

Abstract

Purpose: Prescription drug abuse has reached epidemic proportions. Nonmedical prescription opioid use carries increasingly high costs. Despite the need to cultivate efforts that are both effective and fiscally responsible, the cost-effectiveness of universal evidence-based-preventive-interventions (EBPIs) is rarely evaluated. This study explores the performance of these programs to reduce nonmedical prescription opioid use.

Methods: Sixth graders from twenty-eight rural public school districts in Iowa and Pennsylvania were blocked by size and geographic location and then randomly assigned to experimental or control conditions (2002-2010). Within the intervention communities, prevention teams selected a universal family and school program from a menu of EBPIs. All families were offered a family-based program in the 6th grade and received one of three school-based programs in 7th-grade. The effectiveness and cost-effectiveness of each school program by itself and with an additional family-based program were assessed using propensity and marginal structural models.

Results: This work demonstrates that universal school-based EBPIs can efficiently reduce nonmedical prescription opioid use. Further, findings illustrate that family-based programs may be used to enhance the cost-effectiveness of school-based programs.

Conclusions: Universal EBPIs can effectively and efficiently reduce nonmedical prescription opioid use. These programs should be further considered when developing comprehensive responses to this growing national crisis.

Keywords: Cost-effectiveness; Nonmedical prescription drug use; Prevention economics; Substance abuse; Universal prevention.

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Figures

Figure 1
Figure 1
Study Participation Summary
Figure 2
Figure 2
Decision Tree for Cost-Effectiveness Analysis
Figure 3
Figure 3
Prevalence of nonmedical prescription opioid use among student receiving combined school and family programs
See this image and copyright information in PMC

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