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A cost-effectiveness analysis of modafinil therapy for psychostimulant dependence
James Shearer1, Marian Shanahan, Shane Darke
1Peninsula Medical School, University of Exeter, Exeter, United Kingdom. shearerjames7@gmail.com
Introduction And Aims:
To examine the cost-effectiveness of modafinil (200 mg daily) plus counselling compared with placebo for the treatment of psychostimulant dependence.
Design And Methods:
Cost and outcome data were collected alongside two randomised controlled trials of modafinil 200 mg daily over 10 weeks for methamphetamine (n = 74) and cocaine dependence (n = 8), respectively. Incremental cost-effectiveness ratios representing the additional costs to achieve a given outcome were calculated for both the change in the number of stimulant-free days and quality-adjusted life years 12 weeks post-treatment.
Results:
The incremental cost-effectiveness ratio indicated that it would cost an additional $AUD79 to achieve an extra stimulant-free day with modafinil compared with placebo. This result was not statistically significant, but appeared to be a robust estimate after sensitivity analysis. Counselling, whether received within program or from other services, improved the cost-effectiveness of modafinil relative to placebo.
Discussion And Conclusions:
Strategies to improve the uptake of counselling are recommended as cost-effective.
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