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Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs.

OBJECTIVE: To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers. METHODS: This cost-effectiveness analysis is based on a randomized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network. The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics. Four hundred and fifteen stimulant abusers were assigned to usual care (N=206) or usual care plus abstinence-based incentives (N=209) for 12 weeks. Participants randomized to the incentive condition earned the chance to draw for prizes for submitting substance negative samples; the number of draws earned increased with continuous abstinence time. Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care. The primary patient outcome was longest duration of confirmed stimulant abstinence (LDA). Unit costs were obtained via surveys administered at the eight participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information. RESULTS: The incremental cost to lengthen the LDA by 1 week was 258 US dollars (95% confidence interval, 191-401 US dollars). Sensitivity analyses on several key parameters show that this value ranges from 163 to 269 US dollars. CONCLUSIONS: Compared with the usual care group, the incentive group had significantly longer LDAs and significantly higher costs.

Pubmed ID: 16971054


  • Olmstead TA
  • Sindelar JL
  • Petry NM


Drug and alcohol dependence

Publication Data

March 16, 2007

Associated Grants

  • Agency: NIAAA NIH HHS, Id: P50 AA003510
  • Agency: NIAAA NIH HHS, Id: P50-AA03510
  • Agency: NIDA NIH HHS, Id: P50-DA09241
  • Agency: NIDA NIH HHS, Id: R01 DA013444
  • Agency: NIDA NIH HHS, Id: R01 DA014471
  • Agency: NIDA NIH HHS, Id: R01 DA014618
  • Agency: NIDA NIH HHS, Id: R01 DA016855
  • Agency: NIDA NIH HHS, Id: R01 DA018883
  • Agency: NIDA NIH HHS, Id: R01-DA016855
  • Agency: NIDA NIH HHS, Id: R01-DA018883
  • Agency: NIDA NIH HHS, Id: R01-DA13444
  • Agency: NIDA NIH HHS, Id: R01-DA14471
  • Agency: NIDA NIH HHS, Id: R01-DA14618
  • Agency: NIDA NIH HHS, Id: U10 DA013034
  • Agency: NIDA NIH HHS, Id: U10DA13034

Mesh Terms

  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Counseling
  • Family
  • Female
  • Humans
  • Male
  • Narcotic Antagonists
  • Outpatients
  • Patient Acceptance of Health Care
  • Psychological Tests
  • Reward
  • Social Support
  • Substance-Related Disorders
  • Treatment Outcome