Heroin Dependence Clinical Trial
Official title:
Economic Evaluation Comparing Center-based Compulsory Drug Treatment With Community-based Methadone Maintenance Treatment in Hai Phong City, Vietnam
The study compared the effectiveness and cost-effectiveness of two dominant heroin dependence treatment approaches: center-based compulsory rehabilitation (CCT) and community-based voluntary methadone treatment (MMT) in Hai Phong City, Vietnam. The design was a combined retrospective and prospective, non-randomized cohort over three years (with data at five time-points). The study was conducted between 2012 and 2015, involving 208 CCT participants and 384 MMT participants with heroin dependence.
The study compared the effectiveness and cost-effectiveness of two dominant heroin
dependence treatment approaches: center-based compulsory rehabilitation (CCT) and
community-based voluntary methadone treatment (MMT) in Hai Phong City, Vietnam. CCT centers
are institutions in which people who use drugs are confined for two years. MMT has been
internationally recognized as an efficacious treatment for heroin dependence and was
introduced in Vietnam in 2008.
The design was combined retrospective and prospective, non-randomized cohort over three
years (with data at five time-points). The study was conducted between 2012 and 2014,
involving 208 CCT participants (of which 80% were followed up) and 384 MMT participants (of
which 78% were followed up) with heroin dependence. The five time-points were: baseline, two
years after treatment commencement, then three months, six months and 12 months after the
initial two years. The study combined primary data and secondary data to assess the
effectiveness of the two treatment modalities. The economic component measured the costs of
the two treatment modalities to compare cost-effectiveness outcomes.
The study had two primary outcomes: self-reported heroin abstinence (confirmed by urine drug
screening) and self-reported drug-free days (DFDs). DFDs was reported in two different
time-frames. DFDs in the preceding 30 days was used for effectiveness comparison and DFDs
over three years was used for the cost-effectiveness comparison. The study has four
secondary outcomes: illegal behaviors, overdose, blood-borne virus (BBV) risk behaviors, and
monthly drug spending).
Mixed effects regression models were used to analyze the effectiveness data and
non-parametric bootstrapping methods were used to estimate cost-effectiveness. The
time-frame for the cost-effectiveness analysis was three years.
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