在康涅狄格州减少患有阿片类药物使用障碍的人群中过量死亡
Joy D Scheidell1, Tarlise N Townsend2,3, Qinlian Zhou2
1Department of Health Sciences, University of Central Florida, PO Box 160000, Orlando, FL, 32816, USA. Joy.Scheidell@ucf.edu.
Harm reduction journal
|May 28, 2024
概括
在康涅狄格州最大限度地分配纳洛 (NLX) 和用于阿片类药物使用障碍 (MOUD) 的药物,可以显著减少过量死亡. 结合这些策略提供了最具成本效益的方法来挽救生命和改善公共卫生结果.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 康涅狄格州与药物有关的过量死亡人数超过了交通事故死亡人数.
- 尽管取得了一些进展,但仍需要大幅降低过量服用死亡率.
研究的目的:
- 模拟康涅狄格州扩大过量预防政策的影响.
- 评估纳洛 (NLX) 分发和用于监禁 (MOUD-INC) 和社区 (MOUD-COM) 人群的阿片类药物使用障碍 (MOUD) 药物的成本效益.
主要方法:
- 为患有阿片类药物使用障碍 (OUD) 的人开发和校准了一种机械模拟模型.
- 评估了NLX,MOUD-INC和MOUD-COM单独和组合扩展对5年过量死亡,寿命年和质量调整寿命年 (QALYs) 的影响.
- 从卫生部门和社会角度分析成本,使用3%的折扣率.
主要成果:
- 在有利的ICER中,仅仅最大限度地扩大NLX就能使过量服用的死亡人数减少20% (可注射NLX额外挽救了240人的生命).
- 单靠MOUD-COM和MOUD-INC,死亡率分别降低了14%和6%.
- 将NLX和MOUD-COM一起扩展,在19,000美元/QALY的ICER下,过量服用的死亡人数减少了32%. 社会视角分析显示,在5年内,节省了成本,并减少了33%的过量死亡.
结论:
- 在康涅狄格州,增加纳洛和基于社区的MOUD的规模可以将5年过量死亡率降低32%.
- 考虑到社会成本节约,扩大所有三个政策选择可以将过量服用死亡人数减少三分之一,同时节省成本.
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