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. 2024 May;27(5):655-669.
doi: 10.1016/j.jval.2024.02.004. Epub 2024 Feb 22.

Economic Evaluations of Establishing Opioid Overdose Prevention Centers in 12 North American Cities: A Systematic Review

Czarina N Behrends  1 , Jared A Leff  2 , Weston Lowry  2 , Jazmine M Li  2 , Erica N Onuoha  2 , Erminia Fardone  3 , Ahmed M Bayoumi  4 , Kathryn E McCollister  3 , Sean M Murphy  2 , Bruce R Schackman  2
Affiliations

Economic Evaluations of Establishing Opioid Overdose Prevention Centers in 12 North American Cities: A Systematic Review

Czarina N Behrends et al. Value Health. 2024 May.

Abstract

Objectives: Overdose prevention centers (OPCs) provide a safe place where people can consume preobtained drugs under supervision so that a life-saving medical response can be provided quickly in the event of an overdose. OPCs are programs that are established in Canada and have recently become legally sanctioned in only a few United States jurisdictions.

Methods: We conducted a systematic review that summarizes and identifies gaps of economic evidence on establishing OPCs in North America to guide future expansion of OPCs.

Results: We included 16 final studies that were evaluated with the Consolidated Health Economic Evaluation Reporting Standards and Drummond checklists. Eight studies reported cost-effectiveness results (eg, cost per overdose avoided or cost per quality-adjusted life-year), with 6 also including cost-benefit; 5 reported only cost-benefit results, and 3 cost offsets. Health outcomes primarily included overdose mortality outcomes or HIV/hepatitis C virus infections averted. Most studies used mathematical modeling and projected OPC outcomes using the experience of a single facility in Vancouver, BC.

Conclusions: OPCs were found to be cost-saving or to have favorable cost-effectiveness or cost-benefit ratios across all studies. Future studies should incorporate the experience of OPCs established in various settings and use a greater diversity of modeling designs.

Keywords: cost-effectiveness analysis; overdose prevention centers; systematic literature review.

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Conflict of interest statement

Author Disclosures Author disclosure forms can be accessed in the Supplemental Material section. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies or the US government.

Figures

Figure 1:
Figure 1:
PRISMA Flow Diagram
Figure 2:
Figure 2:
Author Social Network Notes: Co-authorship diagram for authors of two or more publications. The size of each circle is proportional to the number of publications an author is included in. The weight of the lines between authors is proportional to the number of publications both authors appear on. Note: Size of circle is proportional to the number of publications by a given author. Weight of the line between authors is proportional to the number of publications on which both authors appear. For example, Andresen co-authored 5 papers included in this review including 2 with Reid and Jozaghi and another 2 with Jozaghi. Chambers et al. and Khair et al. had no co-authorship with any of the authors in the review and are excluded from the figure.
See this image and copyright information in PMC

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