Substance among women has been shown to have high costs, yet intervention efforts continue to lag behind needs. To address this gap, researchers at Yale University and Washington University of St Louis conducted a randomized controlled trial of various types of health care interventions.

The resulting study, published in PLoS ONE in 2012, “Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial,” considers three types of peer-intervention methods.  The baseline treatment consisted of HIV pre- and post-test counseling, blood collection and results, and a standard intervention for reducing HIV infection (SI). The second treatment included the “well woman exam” (WWE), which provided additional breast and pelvic examinations and a pap smear. The third treatment included four educational sessions (4ES).

The study examines the differences in the outcomes of the WWE and 4ES treatments over four- and 12-month time horizons compared with the baseline treatment.  Key findings include:

• To obtain an additional cocaine abstainer, WWE cost $5,665 at four months and $2,918 at twelve months compared to standard intervention.
• To obtain an additional alcohol abstainer, WWE cost $3,526 at four months and $7,273 at twelve months compared to standard intervention.
• At twelve months, 4ES was more costly and less effective than WWE for abstinence outcomes.
• For nonabstinence outcomes, the interventions generally yielded low incremental cost-effectiveness ratios (ICER).

The authors conclude by noting some of the limitations of their study, including those that relate to sample particularities, data constraints and the types of interventions.

Tags: addiction, drugs, gender, medicine, HIV/AIDS