The National Institute on Drug Abuse estimates that substance use disorders, comprising illicit drugs and alcohol use as well as smoking, cost the United States more than $740 billion per year. This includes the cost of crime, incarceration, lost productivity, and medical care. A recent study considered the economic consequences of heroin use specifically, finding that the annual societal cost of heroin use disorder in the United States is more than $51 billion per year. These costs are staggering placing substance use disorders among the top ten causes of death in the U.S. and translate to more than 7 % of the global burden of disease. Cost-effectiveness analyses of substance use disorder treatment interventions, as well as related HIV and HCV linkage to care or care coordination interventions, typically focus on capturing costs to the healthcare system. Recent guidance from the Second Panel on Cost-Effectiveness in Health and Medicine encourages researchers to broaden their analytic perspective to include multidimensional costs to society, including many indirect costs previously considered in cost-benefit analyses. This guidance includes using an impact inventory that organizes which costs align with the narrower health care system perspective vs. the broader societal perspective.
In order to quantify and value the measures in the impact inventory, CHERISH Methodology Core Co-Director Kathryn McCollister, PhD recently published an article providing an up-to-date summary of relevant monetary conversion factors. Guided by common assessment tools used in substance use disorder research such as the GAIN, ASI, and NMS to select domains and measures, Dr. McCollister used several data sources to create a list of unit costs to monetize societal impacts. She focused on the domains that are relevant for substance use disorders such as medical and behavioral health services, substance use disorder treatment, infectious disease consequences, productivity, criminal activity and criminal justice system contacts, social services, and disability. Coupled with an extensive literature review, this list of monetary conversion factors will serve as a valuable resource for health services and health economics researchers. Considering the article is an update to a study published almost 20 years ago, the authors suggest this exercise be repeated on a regular interval to promote consistency and reproducibility of cost analyses.
The article is available open access in the Journal of Substance Abuse Treatment. Co-authors include Xuan Yang, MPH, MHS, Bisma Sayed, PhD, and Michael French, PhD from the University of Miami, and Jared Leff, MS and Bruce Schackman, PhD from CHERISH and Weill Cornell Medicine.