Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide

Health Services Research, Forthcoming

23 Pages Posted: 29 Oct 2010 Last revised: 25 Oct 2011

See all articles by Jennifer Prah Ruger

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine

Marek Chawarski

Yale School of Medicine

Mahmud Mazlan

Substance Abuse Center

Craig Luekens

Yale University

Nora Y. Ng

Yale University

Richard Schottenfeld

Yale School of Medicine

Date Written: July 17, 2011

Abstract

Objective. Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide.

Data Sources/Study Setting. Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients ( July 2003-May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources.

Study Design. Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita.

Principal Findings. Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29-53 percent) and buprenorphine (33-72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People’s Democratic Republic could be treated for $8 and $30 million, respectively.

Conclusions. Buprenorphine treatment can be provided at low cost in countries across the world. This study’s new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions.

Keywords: Malaysia, Micro-Costing, Gross-Costing, Heroin Treatment, International Comparison, Health System

JEL Classification: I11, I18

Suggested Citation

Prah Ruger, Jennifer and Chawarski, Marek and Mazlan, Mahmud and Luekens, Craig and Ng, Nora Y. and Schottenfeld, Richard, Costs of Addressing Heroin Addiction in Malaysia and 32 Comparable Countries Worldwide (July 17, 2011). Health Services Research, Forthcoming. Available at SSRN: https://ssrn.com/abstract=1698923

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

Marek Chawarski

Yale School of Medicine ( email )

New Haven, CT 06520
United States

Mahmud Mazlan

Substance Abuse Center ( email )

185-1 Jalan Abdul Rahman 84 000
Muar Johor
Malaysia

Craig Luekens

Yale University ( email )

New Haven, CT 06520
United States

Nora Y. Ng

Yale University ( email )

New Haven, CT 06520
United States

Richard Schottenfeld

Yale School of Medicine ( email )

New Haven, CT 06520
United States

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