Estimated cost-effectiveness of diacetylmorphine compared with methadone in the treatment of chronic, refractory opioid dependence
| Time horizon; treatment | Cost, Can$ × 1000, mean (95% CI) | Cost component, % of total | QALYs, mean (95% CI) | Incremental cost-effectiveness ratio, Can$ × 1000 per QALY gained, mean (95% CI) | ||
|---|---|---|---|---|---|---|
| Treatment | Health resources utilization | Criminal activity and charges | ||||
| 1 year | ||||||
| Diacetylmorphine | 85.9 (63.8–116.7) | 17.7 | 4.2 | 78.1 | 0.86 (0.83–0.90) | CS (CS–485.8) |
| Methadone | 87.7 (63.9–119.8) | 3.7 | 6.5 | 89.8 | 0.85 (0.81–0.89) | |
| 5 years | ||||||
| Diacetylmorphine | 387.7 (293.4–511.6) | 12.3 | 8.2 | 79.5 | 3.43 (3.26–3.59) | CS (CS–103.4) |
| Methadone | 418.3 (297.0–579.0) | 2.5 | 11.2 | 86.2 | 3.32 (3.14–3.47) | |
| 10 years | ||||||
| Diacetylmorphine | 696.0 (504.9–960.0) | 10.4 | 11.1 | 78.5 | 5.61 (5.29–5.90) | CS (CS–78.2) |
| Methadone | 743.8 (515.1–1059.7) | 2.3 | 14.0 | 83.8 | 5.39 (5.08–5.67) | |
| Lifetime | ||||||
| Diacetylmorphine | 1096.1 (724.1–1707.2) | 9.3 | 14.1 | 76.7 | 7.92 (7.32–8.53) | CS (CS–122.3) |
| Methadone | 1137.6 (736.8–1776.5) | 2.1 | 16.7 | 81.2 | 7.46 (6.91–8.01) | |
Note: CI = credibility interval, CS = cost-saving, QALY = quality-adjusted life-year.