Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 4;18(1):57.
doi: 10.1186/s13011-023-00565-8.

A cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service

William Rioux  1 , Benjamin Enns  2 , Jennifer Jackson  3 , Hena Quereshi  1 , Mike Irvine  4 , S Monty Ghosh  5   6
Affiliations

A cost benefit analysis of a virtual overdose monitoring service/mobile overdose response service: the national overdose response service

William Rioux et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: The overdose crisis continues across Canada which calls for novel harm reduction strategies. Previous research indicates that a majority of eHealth solutions are cost-effective however current literature on the cost-benefit of eHealth for harm reduction is sparse. The National Overdose Response Service (NORS) is a Canada-wide telephone-based harm reduction service. Service users can call the phone number and connect to a peer who can virtually monitor the substance use session and dispatch appropriate interventions in the case of overdose.

Objectives of the research/project: We aim to assess the cost-benefit of NORS by comparing the estimated cost-savings from prevented overdose mortality to the operating costs of the program, alongside healthcare costs associated with its operation.

Methods: Data around systems costs and operational costs were gathered for our calculations. Our primary outcome was cost-benefit ratios, derived from estimates and models of mortality rates in current literature and value of life lost. We presented our main results across a range of values for costs and the probability of death following an unwitnessed overdose. These values were utilized to calculate cost-benefit ratios and value per dollar spent on service provision by NORS over the length of the program's operation (December 2020-2022).

Results: Over the total funded lifespan of the program, and using a Monte Carlo estimate, the benefit-to-cost ratio of the NORS program was 8.59 (1.53-15.28) per dollar spent, depending on estimated mortality rates following unwitnessed overdose and program operation costs. Further, we conservatively estimate that early community-based naloxone intervention results in healthcare system savings of $4470.82 per overdose response.

Conclusions: We found the NORS program to have a positive benefit-to-cost ratio when the probability of death following an unwitnessed overdose was greater than 5%. NORS and potentially other virtual overdose monitoring services have the potential to be cost-effective solutions for managing the drug poisoning crisis.

Keywords: Cost analysis; Drug poisoning; Emergency services; Mobile overdose response services; Opioids; Overdose.

PubMed Disclaimer

Conflict of interest statement

MG is a co-founder of NORS; MG does not have any financial interest in this work. The results of this work may be used to make operational changes at NORS. The remaining authors are not affiliated with NORS or any other MORS and certify that they have no competing interests.

References

    1. Government of Alberta. COVID-19 info for Albertans [Internet]. [cited 2023 Jul 31]. Available from: https://www.alberta.ca/coronavirus-info-for-albertans.aspx.
    1. Lee Y, Lui LMW, Brietzke E, Liao Y, Lu C, Ho R, et al. Comparing mortality from covid-19 to mortality due to overdose: a micromort analysis. J Affect Disord. 2022;296:514–21. doi: 10.1016/j.jad.2021.09.059. - DOI - PMC - PubMed
    1. Federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and Stimulant-related Harms in Canada. [Internet]. Ottawa: Public Health Agency of Canada; 2023 [cited 2023 Jul 31]. Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimul....
    1. Canadian Substance Use Costs and Harms Scientific Working Group. Canadian substance use costs and harms 2015–2017. [Internet]. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction.; 2020 [cited 2023 Mar 1]. Available from: https://csuch.ca/publications/CSUCH-Canadian-Substance-Use-Costs-Harms-R....
    1. Recovery Centers of America. Economic cost of substance abuse disorder in the United States, 2019 [Internet]. [cited 2022 Dec 12]. Available from: https://recoverycentersofamerica.com/resource/economic-cost-of-substance....

Publication types

Grants and funding