دانلود مقاله انگلیسی رایگان:تجزیه و تحلیل مقرون به صرفه استراتژی های توزیع naloxone جایگزین: اولین پاسخ دهنده و توزیع در ایالات متحده - 2020
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  • Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States
    Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States

    سال انتشار:

    2020


    عنوان انگلیسی مقاله:

    Cost-effectiveness analysis of alternative naloxone distribution strategies: First responder and lay distribution in the United States


    ترجمه فارسی عنوان مقاله:

    تجزیه و تحلیل مقرون به صرفه استراتژی های توزیع naloxone جایگزین: اولین پاسخ دهنده و توزیع در ایالات متحده


    منبع:

    Sciencedirect - Elsevier - International Journal of Drug Policy, 75 (2020) 102536. doi:10.1016/j.drugpo.2019.07.031


    نویسنده:

    Tarlise Townsenda,b,*, Freida Blosteina, Tran Doana, Samantha Madson-Olsona, Paige Galeckia, David W. Huttona


    چکیده انگلیسی:

    Background: The U.S. is facing an unprecedented number of opioid-related overdose deaths, and an array of other countries have experienced increases in opioid-related fatalities. In the U.S., naloxone is increasingly distributed to first responders to improve early administration to overdose victims, but its cost-effectiveness has not been studied. Lay distribution, in contrast, has been found to be cost-effective, but rising naloxone prices and increased mortality due to synthetic opioids may reduce cost-effectiveness. We evaluate the cost-effectiveness of increased naloxone distribution to (a) people likely to witness or experience overdose (“laypeople”); (b) police and firefighters; (c) emergency medical services (EMS) personnel; and (d) combinations of these groups. Methods: We use a decision-analytic model to analyze the cost-effectiveness of eight naloxone distribution strategies. We use a lifetime horizon and conduct both a societal analysis (accounting for productivity and criminal justice system costs) and a health sector analysis. We calculate: the ranking of strategies by net monetary benefit; incremental cost-effectiveness ratios; and number of fatal overdoses. Results: High distribution to all three groups maximized net monetary benefit and minimized fatal overdoses; it averted 21% of overdose deaths compared to minimum distribution. High distribution to laypeople and one of the other groups comprised the second and third best strategies. The majority of health gains resulted from increased lay distribution. In the societal analysis, every strategy was cost-saving compared to its next-best alternative; cost savings were greatest in the maximum distribution strategy. In the health sector analysis, all undominated strategies were cost-effective. Results were highly robust to deterministic and probabilistic sensitivity analysis. Conclusions: Increasing naloxone distribution to laypeople and first responder groups would maximize health gains and be cost-effective. If feasible, communities should distribute naloxone to all groups; otherwise, distribution to laypeople and one of the first responder groups should be emphasized.
    Keywords: Opioids | Naloxone | Cost-effectiveness analysis | Overdose | First responders | Take-home


    سطح: متوسط
    تعداد صفحات فایل pdf انگلیسی: 9
    حجم فایل: 1003 کیلوبایت

    قیمت: رایگان


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