A cost analysis of a peer support-driven intervention for substance use disorders

Background: Peer recovery support services (PRSS) improve engagement and retention in treatment for substance use disorders (SUDs), but limited evidence exists on their economic effectiveness. Understanding implementation costs may inform replication efforts of PRSS.Objective: This study evaluated the costs of implementing the Substance Use Disorder Telehealth Treatment in the Emergency Department/Inpatient Units by Peer Support Workers (PSWs) (STTEP) program at a hospital in New Mexico, and how to make the implementation more efficient if replicated elsewhere.Methods: The STTEP program identified adults at risk of an SUD in emergency and inpatient settings and facilitated treatment linkage and retention. Cost data were collected from 11/2022 to 11/2023 using the Drug Abuse Treatment Cost Analysis Program covering personnel, facilities, equipment, and other expenses. We estimated precise costs associated with implementing the STTEP program. We extrapolated potential costs of implementing this intervention using estimates for participant engagement time, resource use, idle time, PSW turnover, participant no-show rates, and number of participants served. Finally, we conducted a sensitivity analysis by varying these factors.Results: The annual cost for the STTEP program was $256,150.10 (average per-participant cost of $3,201.88). Most costs were related to personnel (91.42%). Extrapolated results, which include modified aspects such as idle no-show rates and PSW turnover rate, indicated that a more efficient program could operate at $117,043.70 annually, with an average per-participant cost of $1,463.05.Conclusions: Expanding the responsibilities of PSWs to better utilize downtime and reducing turnover and no-show rates could improve efficiency and lower costs of PRSS.