PRSS / Naloxone Calculator

This tab displays the cost-effectiveness calculator for long-term, peer recovery support services delivered after specialty substance use disorder treatment at a recovery community organization. If you would like to use the cost-effectiveness calculator for bystander naloxone distribution at a recovery community organization, please use the tab above to navigate to that section.

How many people served?

What percentage of participants are retained to 1 year or to successful completion of long-term peer recovery support services?

Of those retained, what percentage of participants are still in recovery at graduation/1 year? (Please use the definition of recovery or success that your organization uses.)

Average age of participants

What is the average number of engagements that your participants have with their peer worker over the course of long-term peer recovery support services?

What is the average length of a participant's engagement with a peer worker in long-term peer recovery support services? Please report in minutes. Please add the estimated time for the peer worker to complete paperwork related to each encounter to this total.

What is the hourly pay for peer workers at your organization?

SOCIETAL PERSPECTIVE RESULTS

Societal Perspective Results: Averted Costs to Society

Long-term PRSS saves society this much over specialty SUD treatment alone at one year post-treatment (total cost). These societal costs include things like criminal justice system costs, and some kinds of medical costs other than treatment. It does not include productivity costs, because those are accounted for in the quality of life adjustments made in the Quality-Adjusted Life Expectancy results.

Per individual served, PRSS saves the society this much over specialty SUD treatment alone at one year post-treatment.

Societal Perspective Results: Difference in Quality-Adjusted Life Expectancy (Incremental Effects)

Long-term PRSS delivered to all of your participants will produce approximately this many additional years of life expectancy, adjusted for quality of life, compared to specialty SUD treatment alone.

That translates to this many additional years of life expectancy per person.

Societal Perspective Results: Difference in Number of People in Recovery (Incremental Effects)

This many more people are retained in recovery when they receive long-term PRSS at three years post-treatment, compared to receiving treatment alone.

Societal Perspective Results: Incremental Cost-Effectiveness Ratio (ICER) for Quality-Adjusted Life Expectancy

Is it cost-effective compared to the $50,000 threshold?

Is it cost-effective compared to the $100,000 threshold?

Is it cost-effective compared to the $200,000 threshold?

Is it cost-effective compared to the cost of another specialty SUD treatment episode?

Is it cost-saving? (Remember, it doesn't have to be cost-saving to be efficient)

Societal Perspective Results: Incremental Cost-Effectiveness Ratio (ICER) for Cost per Person in Recovery

Is it cost-effective compared to the $50,000 threshold?

Is it cost-effective compared to the $100,000 threshold?

Is it cost-effective compared to the $200,000 threshold?

Is it cost-effective compared to the cost of another specialty SUD treatment episode?

Is it cost-saving? (Remember, it doesn't have to be cost-saving to be efficient)

HEALTH SYSTEM PERSPECTIVE RESULTS

Health System Perspective Results: Averted Medical Costs

Long-term PRSS avoids hospitalizations and emergency department visits that cost this much over specialty SUD treatment alone at one year post-treatment (total cost).

Per individual served, PRSS saves this much in averted hospitalizations and emergency department visits over specialty SUD treatment alone at one year post-treatment.

Health System Perspective Results: Difference in Quality-Adjusted Life Expectancy (Incremental Effects)

Long-term PRSS delivered to all of your participants will produce approximately this many additional years of life expectancy, adjusted for quality of life, compared to specialty SUD treatment alone.

That translates to this many additional years of life expectancy per person.

Health System Perspective Results: Difference in Number of People Retained in Recovery (Incremental Effects)

This many more people are retained in recovery when they receive long-term PRSS at three years post-treatment, compared to receiving treatment alone.

Health System Perspective Results: Incremental Cost-Effectiveness Ratio (ICER)

Is it cost-effective compared to the $50,000 threshold?

Is it cost-effective compared to the $100,000 threshold?

Is it cost-effective compared to the $200,000 threshold?

Is it cost-effective compared to the cost of another specialty SUD treatment episode?

Is it cost-saving? (Remember, it doesn't have to be cost-saving to be efficient)

Health System Perspective Results: Incremental Cost-Effectiveness Ratio (ICER) for Cost per Person in Recovery

Is it cost-effective compared to the $50,000 threshold?

Is it cost-effective compared to the $100,000 threshold?

Is it cost-effective compared to the $200,000 threshold?

Is it cost-effective compared to the cost of another specialty SUD treatment episode?

Is it cost-saving? (Remember, it doesn't have to be cost-saving to be efficient)

This tab displays the cost-effectiveness calculator for bystander naloxone distribution at a recovery community organization. If you would like to use the cost-effectiveness calculator for long-term peer recovery support services, please use the tab above to navigate to that section.

What percentage of participants would you like to serve? (background assumption that 20% of opioid users already have naloxone in their possession)

Cost of naloxone (nasal spray)

Incremental Costs

Cost of Bystander Naloxone Distribution

Cost of Treatment as Usual (probability of EMS transport, hospital treatment, and related costs)

Difference

Incremental Effects

A Bystander Naloxone Distribution program distributing naloxone to the above percentage of your participants will produce approximately this many additional years of life expectancy per 1,000 participants, adjusted for quality of life, compared to standard treatment.

Incremental Cost-effectiveness Ratio (ICER) for Qualify Adjusted Life Expectancy

Cost-Effectiveness Threshold

Is it cost-effective compared to the $50,000 threshold?

Is it cost-effective compared to the $100,000 threshold?

Is it cost-effective compared to the $200,000 threshold?

Lives Saved

Lives saved in year 1 of Bystander Naloxone Distribution

Lives saved by year 3 of Bystander Naloxone Distribution

View a webinar providing background information on the project, information about using and interpreting cost-effectiveness information, and a tutorial of how to use the calculator.

This project was made possible by funding from the Recovery Research Institute, NIDA R24DA051988 Pilot Grant. This study was reviewed by the UTHealth Houston Committee for the Protection of Human Subjects and declared exempt, IRB# HSC-SPH-21-1057.

Principal Investigator: H. Shelton Brown, III, PhD, [email protected]

Graduate Research Assistants:

Sierra Castedo de Martell, PhD, MPH, (PRSS lead) [email protected]
Margaret Brannon Moore, MPH, LLM, JD, (bystander naloxone lead) [email protected]

Please contact the research team with additional questions or feedback.

We welcome your feedback at the following link: https://redcap.link/calculator.

Acknowledgements: In addition to funding from the Recovery Research Institute, this project was made possible thanks to the extensive feedback provided by two Austin, Texas-based recovery community organizations: Communities for Recovery and RecoveryATX.

COMPARISON OF COST-EFFECTIVENESS OF OTHER INTERVENTIONS

Treatment

Cost to Buy One Quality-Adjusted Life Year (QALY)

Cost-Effective

Beta blockers for high-risk patients after heart attack

Less than $5,000

Beta blockers for high-risk patients after heart attack

Less than $5,000

Combination antiretroviral therapy for HIV/AIDS

$10,000 - 20,000

Treatment of moderate hypertension

$20,000 - 50,000

Dialysis for end-stage kidney failure

$50,000 - 100,000

Not Cost Effective

Lung Transplatation

More than $100,000

MRI screening for dementia

More than $500,000

Annual (vs. biennial) pap smear

$800,000