TY  - JOUR
IS  - 9
EP  - 1627
SP  - 1616
TI  - An economic evaluation of contingency management for completion of hepatitis B vaccination in those on treatment for opiate dependence
PB  - Wiley
A1  - Rafia, Rachid
A1  - Dodd, Peter J.
A1  - Brennan, Alan
A1  - Meier, Petra S.
A1  - Hope, Vivian D.
A1  - Ncube, Fortune
A1  - Byford, Sarah
A1  - Tie, Hiong
A1  - Metrebian, Nicola
A1  - Hellier, Jennifer
A1  - Weaver, Tim
A1  - Strang, John
ID  - enlighten222989
UR  - https://eprints.gla.ac.uk/222989/
JF  - Addiction
Y1  - 2016/09//
AV  - public
N2  - 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%.
N1  - 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).
SN  - 0965-2140
VL  - 111
ER  -