%0 Journal Article
%@ 0965-2140
%A Rafia, Rachid
%A Dodd, Peter J.
%A Brennan, Alan
%A Meier, Petra S.
%A Hope, Vivian D.
%A Ncube, Fortune
%A Byford, Sarah
%A Tie, Hiong
%A Metrebian, Nicola
%A Hellier, Jennifer
%A Weaver, Tim
%A Strang, John
%D 2016
%F enlighten:222989
%I Wiley
%J Addiction
%N 9
%P 1616-1627
%R 10.1111/add.13385
%T An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
%U https://eprints.gla.ac.uk/222989/
%V 111
%X Aims:     To determine whether the provision of contingency management using financial incentives to improve hepatitis B vaccine completion in people who inject drugs entering community treatment represents a cost‐effective use of health‐care resources.    Design:     A probabilistic cost‐effectiveness analysis was conducted, using a decision‐tree to estimate the short‐term clinical and health‐care cost impact of the vaccination strategies, followed by a Markov process to evaluate the long‐term clinical consequences and costs associated with hepatitis B infection.    Settings and participants:     Data on attendance to vaccination from a UK cluster randomized trial.    Intervention:     Two contingency management options were examined in the trial: fixed versus escalating schedule financial incentives.    Measurement:     Life‐time health‐care costs and quality‐adjusted life years discounted at 3.5% annually; incremental cost‐effectiveness ratios.    Findings:     The resulting estimate for the incremental life‐time health‐care cost of the contingency management strategy versus usual care was £21.86 [95% confidence interval (CI) = –£12.20 to 39.86] per person offered the incentive. For 1000 people offered the incentive, the incremental reduction in numbers of hepatitis B infections avoided over their lifetime was estimated at 19 (95% CI = 8–30). The probabilistic incremental cost per quality adjusted life‐year gained of the contingency management programme was estimated to be £6738 (95% CI = £6297–7172), with an 89% probability of being considered cost‐effective at a threshold of £20 000 per quality‐adjusted life years gained (97.60% at £30 000).    Conclusions:     Using financial incentives to increase hepatitis B vaccination completion in people who inject drugs could be a cost‐effective use of health‐care resources in the UK as long as the incidence remains above 1.2%.
%Z This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference no. RP‐PG‐0707‐10 149).