A cost-benefit and cost-effectiveness analysis of Vancouver’s Supervised Injection Facility Andresen, Martin A.; Boyd, Neil
Background: A supervised injection facility has been established in North America: Insite, in Vancouver, British Columbia. The purpose of this paper is to conduct a cost – effectiveness and cost – benefit analysis of this supervised injection facility using secondary data gathered and analyzed in 2008. In using these data we seek to determine whether the facility’s prevention of infections and deaths among injection drug users is of greater or lesser economic cost than the cost involved in providing this service – Insite – to this community. Methods: Mathematical modeling is used to estimate the number of new HIV infections and deaths prevented each year. We use the number of these new HIV infections and deaths prevented, in conjunction with estimated lifetime public health care costs of a new HIV infection, and the value of a life, in order to calculate an identifiable portion of the societal benefits of Insite. The annual costs of operating the supervised injection facility are used to measure the social costs of Insite. In using this information, we calculate cost-effectiveness and benefit-cost ratios for the supervised injection facility. Results: Through the use of conservative estimates, Vancouver’s supervised injection facility, Insite, on average, prevents 35 new cases of HIV and almost 3 deaths each year. This provides a societal benefit in excess of $6 million per year after the program costs are taken into account, translating into an average benefit-cost ratio of 5.12 : 1. Conclusion: Vancouver’s supervised injection facility appears to be an effective and efficient use of public health care resources, based on a modeling study of only two specific and measureable benefits – HIV infection and overdose death.
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