Guinness, L., Vickerman, P., Quayyum, Z., Foss, A., Watts, C., Rodericks, A., Azim, T., Jana, S. and Kumaranayake, L. (2010) The cost-effectiveness of consistent and early intervention of harm reduction for injecting drug users in Bangladesh. Addiction, 105(2), pp. 319-328. (doi: 10.1111/j.1360-0443.2009.02755.x)
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Publisher's URL: http://dx.doi.org/10.1111/j.1360-0443.2009.02755.x
Abstract
Aims: To assess the cost-effectiveness of the CARE-SHAKTI harm reduction intervention for injecting drug users (IDUs) over a 3-year period, the impact on the cost-effectiveness of stopping after 3 years and how the cost-effectiveness might vary with baseline human immunodeficiency virus (HIV) prevalence.<p></p> Design: Economic cost data were collected from the study site and combined with impact estimates derived from a dynamic mathematical model.<p></p> Setting: Dhaka, Bangladesh, where the HIV prevalence has remained low despite high-risk sexual and injecting behaviours, and growing HIV epidemics in neighbouring countries.<p></p> Findings: The cost per HIV infection prevented over the first 3 years was US$110.4 (33.1–182.3). The incremental cost-effectiveness of continuing the intervention for a further year, relative to stopping at the end of year 3, is US$97 if behaviour returns to pre-intervention patterns. When baseline IDU HIV prevalence is increased to 40%, the number of HIV infections averted is halved for the 3-year period and the cost per HIV infection prevented doubles to US$228.<p></p> Conclusions: The analysis confirms that harm reduction activities are cost-effective. Early intervention is more cost-effective than delaying activities, although this should not preclude later intervention. Starting harm reduction activities when IDU HIV prevalence reaches as high as 40% is still cost-effective. Continuing harm reduction activities once a project has matured is vital to sustaining its impact and cost-effectiveness.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Quayyum, Dr Zahidul |
| Authors: | Guinness, L., Vickerman, P., Quayyum, Z., Foss, A., Watts, C., Rodericks, A., Azim, T., Jana, S., and Kumaranayake, L. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment |
| Journal Name: | Addiction |
| Publisher: | Wiley |
| ISSN: | 0965-2140 |
| ISSN (Online): | 1360-0443 |
| Related URLs: |
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