Distributing Naloxone to Heroin Users Likely Cost-Effective

Scenarios show lay administration would be cost-effective, even under conservative assumptions

FRIDAY, Jan. 4 (HealthDay News) -- Distributing naloxone to heroin users for lay administration for overdose reversal would be cost-effective and likely reduce overdose deaths, according to a study published in the Jan. 1 issue of the Annals of Internal Medicine.

Phillip O. Coffin, M.D., from the San Francisco Department of Public Health, and Sean D. Sullivan, Ph.D., from the University of Washington in Seattle, used published literature calibrated to epidemiological data to analyze scenarios involving a hypothetical 21-year-old novice U.S. heroin user and more experienced users to estimate the cost-effectiveness of distributing naloxone. The overdose deaths prevented and incremental cost-effectiveness ratio (ICER) were assessed using deterministic and probabilistic analyses.

In the best-case analysis, the researchers found that 6 percent of overdose deaths would be prevented with naloxone distribution, with distribution of 227 naloxone kits necessary to prevent one death. Distribution of naloxone correlated with a $53 increase in costs and a 0.119 increase in quality-adjusted life-years, for an ICER of $438. In a worse-case scenario, the estimated ICER was $14,000, where overdose was rarely witnessed and naloxone was seldom used, minimally effective, and expensive. Application of national drug-related expenditures to heroin users would result in an ICER of $2,429. In all deterministic and probabilistic sensitivity and scenario analyses, naloxone distribution was considered to be cost-effective, and if it resulted in fewer overdoses or emergency medical service activations, it was considered cost-saving.

"Naloxone distribution to heroin users is likely to reduce overdose deaths and is cost-effective, even under markedly conservative assumptions," the authors write.

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