This paper examines whether disclosure of pharmaceutical industry payments to physicians reduces branded prescribing by disclosed physicians in hospital care. The basis of disclosure is the threat of reputational consequences; however, it is not clear that reputational incentives (either social or financial) will be particularly strong in the hospital context. Using hospital discharge data from the New Jersey Department of Health, I exploit a unique natural experiment in which physicians are observed after receiving payments but before they are aware that they will be disclosed. Using differences-in-differences to compare within-physician prescriptions of branded drugs before and after their payments were disclosed, I find that disclosure does not induce cost consciousness as hoped: disclosure led to a 0.8 percentage point increase in the share of branded drugs by disclosed physicians relative to undisclosed physicians.
本文探讨是否披露制药行业支付给医生减少品牌处方披露医生在医院护理。披露的基础是声誉后果的威胁;然而，目前尚不清楚声誉激励(无论是社会的还是经济的)在医院的背景下会特别强。我利用新泽西州卫生部(New Jersey Department of Health)的出院数据，进行了一项独特的自然实验:在医生收到付款后，但在他们意识到付款将被披露之前，对他们进行了观察。使用差异中的差异来比较医生在付款披露前后对品牌药的处方，我发现披露并没有像希望的那样引起成本意识:披露导致披露的医生相对于未披露的医生，品牌药的份额增加了0.8个百分点。
{"title":"Can Disclosure of Pharmaceutical Industry Payments Induce Cost Conscious Prescribing? Evidence from New Jersey","authors":"Sara Parker-Lue","doi":"10.2139/ssrn.3751124","DOIUrl":"https://doi.org/10.2139/ssrn.3751124","url":null,"abstract":"This paper examines whether disclosure of pharmaceutical industry payments to physicians reduces branded prescribing by disclosed physicians in hospital care. The basis of disclosure is the threat of reputational consequences; however, it is not clear that reputational incentives (either social or financial) will be particularly strong in the hospital context. Using hospital discharge data from the New Jersey Department of Health, I exploit a unique natural experiment in which physicians are observed after receiving payments but before they are aware that they will be disclosed. Using differences-in-differences to compare within-physician prescriptions of branded drugs before and after their payments were disclosed, I find that disclosure does not induce cost consciousness as hoped: disclosure led to a 0.8 percentage point increase in the share of branded drugs by disclosed physicians relative to undisclosed physicians.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124180115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic has been especially devastating for people with disabilities, as well as other members of marginalized communities Indeed, an emerging body of scholarship has revealed striking disparities experienced by people with disabilities In particular, scholars have shined a light on issues relating to triage policies that allow for the rationing of critical health care and resources, such as ventilators, for people with disabilities if resources become limited and hospitals cannot treat all patients during the pandemic These injustices are a deserving issue that urgently warrants extensive consideration by policymakers, legal professionals, and scholars At the same time, however, it is crucial to elucidate the ways in which the inequities people with disabilities are experiencing during COVID-19 are the result of deeply rooted injustices that have endured over time To do so, a comprehensive analysis of the inequalities experienced by people with disabilities before and during the pandemic is needed, focused on understanding how law and policy affect these disparities This Article, therefore, builds on, incorporates, and extends the existing scholarship about COVID-19 and disabled people by positioning it within the health justice framework and proposing normative legal and policy solutions to address deeply entrenched inequities that will affect people with during the COVID-19 pandemic and beyond
{"title":"Applying the Health Justice Framework to Address Health and Health Care Inequities Experienced by People with Disabilities During and After COVID-19","authors":"R. Powell","doi":"10.2139/ssrn.3687730","DOIUrl":"https://doi.org/10.2139/ssrn.3687730","url":null,"abstract":"The COVID-19 pandemic has been especially devastating for people with disabilities, as well as other members of marginalized communities Indeed, an emerging body of scholarship has revealed striking disparities experienced by people with disabilities In particular, scholars have shined a light on issues relating to triage policies that allow for the rationing of critical health care and resources, such as ventilators, for people with disabilities if resources become limited and hospitals cannot treat all patients during the pandemic These injustices are a deserving issue that urgently warrants extensive consideration by policymakers, legal professionals, and scholars At the same time, however, it is crucial to elucidate the ways in which the inequities people with disabilities are experiencing during COVID-19 are the result of deeply rooted injustices that have endured over time To do so, a comprehensive analysis of the inequalities experienced by people with disabilities before and during the pandemic is needed, focused on understanding how law and policy affect these disparities This Article, therefore, builds on, incorporates, and extends the existing scholarship about COVID-19 and disabled people by positioning it within the health justice framework and proposing normative legal and policy solutions to address deeply entrenched inequities that will affect people with during the COVID-19 pandemic and beyond","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131341798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The weight loss market is attractive and the internet generates opportunities for this business. It was intended to understand whether digital marketing has positive effects on choosing a weight loss program. A literature review and a survey were carried out: 2 online surveys and telephone interviews. Survey 1 was carried out with 100 people and survey 2 and interviews with nutritionists / doctors specialized in weight loss, 100 and 55, respectively. SPSS was used. 49% of respondents who wanted to lose weight and searched on the internet, started the programs surveyed. 72.5% of professionals promote their doctor’s appointments on the internet and 62.7% classify digital marketing as “very effective” or “essential effect” when choosing a weight loss program. It was concluded that the internet is a good dissemination tool for professionals in this area and influences consumer choice, demonstrating the positive effects of digital marketing when choosing a weight loss program.
{"title":"The Effects of Digital Marketing on Choosing a Weight Loss Program","authors":"Joana Lima, J. Peixoto","doi":"10.2139/ssrn.3683814","DOIUrl":"https://doi.org/10.2139/ssrn.3683814","url":null,"abstract":"The weight loss market is attractive and the internet generates opportunities for this business. It was intended to understand whether digital marketing has positive effects on choosing a weight loss program. A literature review and a survey were carried out: 2 online surveys and telephone interviews. Survey 1 was carried out with 100 people and survey 2 and interviews with nutritionists / doctors specialized in weight loss, 100 and 55, respectively. SPSS was used. 49% of respondents who wanted to lose weight and searched on the internet, started the programs surveyed. 72.5% of professionals promote their doctor’s appointments on the internet and 62.7% classify digital marketing as “very effective” or “essential effect” when choosing a weight loss program. It was concluded that the internet is a good dissemination tool for professionals in this area and influences consumer choice, demonstrating the positive effects of digital marketing when choosing a weight loss program.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121439868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Governments around the world have adopted unprecedented policies to deal with COVID-19. This paper zooms in on business shutdowns and investigates their effectiveness in reducing mortality. We leverage upon highly granular death registry data for over 4,000 Italian municipalities in a diff-in-diff approach that allows us to credibly mitigate endogeneity concerns. Our results, which are robust to controlling for a host of co-factors, offer strong evidence that business shutdowns are very effective in reducing mortality. We calculate that the death toll from the first wave of COVID-19 in Italy would have been twice as high in their absence. Our findings also highlight that timeliness is key: by acting one week earlier, the government could have reduced the death toll by an additional 25%. Finally, our estimates suggest that shutdowns should be targeted: closing shops, bars and restaurants saves the most lives, while shutting down manufacturing and construction activities has only mild effects.
{"title":"Business Shutdowns and COVID-19 Mortality","authors":"G. Ciminelli, S. Garcia-Mandicó","doi":"10.2139/ssrn.3683324","DOIUrl":"https://doi.org/10.2139/ssrn.3683324","url":null,"abstract":"Governments around the world have adopted unprecedented policies to deal with COVID-19. This paper zooms in on business shutdowns and investigates their effectiveness in reducing mortality. We leverage upon highly granular death registry data for over 4,000 Italian municipalities in a diff-in-diff approach that allows us to credibly mitigate endogeneity concerns. Our results, which are robust to controlling for a host of co-factors, offer strong evidence that business shutdowns are very effective in reducing mortality. We calculate that the death toll from the first wave of COVID-19 in Italy would have been twice as high in their absence. Our findings also highlight that timeliness is key: by acting one week earlier, the government could have reduced the death toll by an additional 25%. Finally, our estimates suggest that shutdowns should be targeted: closing shops, bars and restaurants saves the most lives, while shutting down manufacturing and construction activities has only mild effects.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131717001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The fetal origins hypothesis suggests that health and nutrition shocks in utero are causally related to health deficits in old age. It has received considerable empirical support, both within epidemiology and economics but so far it has not been integrated into a life cycle theory of human aging and longevity. The present study shows that the health deficit model, based on the frailty index developed in gerontology, generates shock amplification consistent with the hypothesis. In order to discuss human health over the life cycle from conception to death, we develop a theory of ontogenetic growth and health in utero and during childhood, unify it with the health deficit model of adult aging, and discuss the transmission of early-life shocks to late-life health deficit accumulation.
{"title":"Fetal Origins – A Life Cycle Model of Health and Aging from Conception to Death","authors":"Carl‐Johan Dalgaard, C. W. Hansen, H. Strulik","doi":"10.2139/ssrn.3676933","DOIUrl":"https://doi.org/10.2139/ssrn.3676933","url":null,"abstract":"The fetal origins hypothesis suggests that health and nutrition shocks in utero are causally related to health deficits in old age. It has received considerable empirical support, both within epidemiology and economics but so far it has not been integrated into a life cycle theory of human aging and longevity. The present study shows that the health deficit model, based on the frailty index developed in gerontology, generates shock amplification consistent with the hypothesis. In order to discuss human health over the life cycle from conception to death, we develop a theory of ontogenetic growth and health in utero and during childhood, unify it with the health deficit model of adult aging, and discuss the transmission of early-life shocks to late-life health deficit accumulation.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"120 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122174087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We investigate how patient ability to pay through insurance influences the equity of care given by Emergency Medical Service (EMS) crews following 9-1-1 calls. EMS agencies are often underfunded and rely on self-generated revenues to carry out their health mission. Revenues depend on insurance reimbursement rates that typically decrease in the following order: private insurance, Medicare, and Medicaid. Reimbursement rate differences provide strong organizational-level incentives to treat patients differently based on ability to pay, but it is unclear if such differences might impact individual-level behaviors in the absence of direct incentives. Using data from 31 states reported to the US National Emergency Medical Services Information System, we find that both private insurance and Medicare patients receive more procedures (4.6% and 1.5%) and have longer transport times (5.1% and 3.9%) than Medicaid patients. These differences reduce with call urgency but increase on busy days. Differences manifest across all agency types but particularly in larger agencies and agencies with fewer private insurance calls in the recent past. While EMS crews do not benefit directly from patient payments, our results suggest they do respond to indirect organization-level incentives when making care decisions.
{"title":"Making Them Pay? Patient Ability to Pay and Care Disparities in Emergency Medical Services","authors":"Timothy Gubler, Haibo Liu, A. Roman","doi":"10.2139/ssrn.3672573","DOIUrl":"https://doi.org/10.2139/ssrn.3672573","url":null,"abstract":"We investigate how patient ability to pay through insurance influences the equity of care given by Emergency Medical Service (EMS) crews following 9-1-1 calls. EMS agencies are often underfunded and rely on self-generated revenues to carry out their health mission. Revenues depend on insurance reimbursement rates that typically decrease in the following order: private insurance, Medicare, and Medicaid. Reimbursement rate differences provide strong organizational-level incentives to treat patients differently based on ability to pay, but it is unclear if such differences might impact individual-level behaviors in the absence of direct incentives. Using data from 31 states reported to the US National Emergency Medical Services Information System, we find that both private insurance and Medicare patients receive more procedures (4.6% and 1.5%) and have longer transport times (5.1% and 3.9%) than Medicaid patients. These differences reduce with call urgency but increase on busy days. Differences manifest across all agency types but particularly in larger agencies and agencies with fewer private insurance calls in the recent past. While EMS crews do not benefit directly from patient payments, our results suggest they do respond to indirect organization-level incentives when making care decisions.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124239447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite claims by anti-mass-incarceration advocates attempting to use coronavirus to argue for early release, evidence shows that inmates are significantly more safe in prison than set free.
{"title":"Coronavirus and Mass Incarceration","authors":"Michael Conklin","doi":"10.2139/ssrn.3613236","DOIUrl":"https://doi.org/10.2139/ssrn.3613236","url":null,"abstract":"Despite claims by anti-mass-incarceration advocates attempting to use coronavirus to argue for early release, evidence shows that inmates are significantly more safe in prison than set free.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122235625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The risk of AIDS-related mortality increased dramatically throughout the 1990s. This paper updates previous work by Fortson (2011) to examine the impact of mortality risk on human capital investment during the deadliest period of the pandemic. We combine Demographic Health Survey data from 30 countries, across 60 survey waves, to generate a sample of over 1,300,000 observations. Cohort-specific analysis using the updated sample yields new evidence that the negative relationship between HIV prevalence and schooling steepened as mortality risk increased. The reduction in schooling is largest for women, and along the extensive margin of the schooling decision. The findings indicate that the decline in human capital investment associated with the HIV/AIDS pandemic prior to the availability of treatment was larger in magnitude than previously understood, but may be reversing rapidly as access to treatment is expanded.
{"title":"The Impact of HIV/AIDS on Human Capital Investment in Sub-Saharan Africa: New Evidence","authors":"L. Chicoine, Emily R. Lyons, Alexia Sahue","doi":"10.2139/ssrn.3437138","DOIUrl":"https://doi.org/10.2139/ssrn.3437138","url":null,"abstract":"The risk of AIDS-related mortality increased dramatically throughout the 1990s. This paper updates previous work by Fortson (2011) to examine the impact of mortality risk on human capital investment during the deadliest period of the pandemic. We combine Demographic Health Survey data from 30 countries, across 60 survey waves, to generate a sample of over 1,300,000 observations. Cohort-specific analysis using the updated sample yields new evidence that the negative relationship between HIV prevalence and schooling steepened as mortality risk increased. The reduction in schooling is largest for women, and along the extensive margin of the schooling decision. The findings indicate that the decline in human capital investment associated with the HIV/AIDS pandemic prior to the availability of treatment was larger in magnitude than previously understood, but may be reversing rapidly as access to treatment is expanded.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121700132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faced with major crises, policymakers are at risk of various pathologies Even in the absence of such pathologies, governments, when faced with a major crisis such as the COVID-19 pandemic, have strong incentives to try to go it alone at the national level: Both policy implementation and political accountability still mostly take place at the national level. Federal political systems, such as Germany, face similar challenges at the sub-national level. At the same time, Louis Brandeis' classic depiction of U.S. states as "laboratories of democracy" reminds us that federalism offers opportunities for trying different policy responses and learning from the differing results, especially when federalism has "experimentalist" characteristics to encourage feedback and learning. We provide a brief overview of the public and political discourse in Germany, as well as the German federal and state-level policy responses, during the first months of the pandemic and an early, tentative assessment of commonalities, divergence, pathologies, and learning – as well as broader implications for conflict and cooperation in Europe and beyond.
{"title":"Policy Responses to the Coronavirus in Germany","authors":"Tim Buthe, Luca Messerschmidt, Cindy Cheng","doi":"10.2139/ssrn.3614794","DOIUrl":"https://doi.org/10.2139/ssrn.3614794","url":null,"abstract":"Faced with major crises, policymakers are at risk of various pathologies Even in the absence of such pathologies, governments, when faced with a major crisis such as the COVID-19 pandemic, have strong incentives to try to go it alone at the national level: Both policy implementation and political accountability still mostly take place at the national level. Federal political systems, such as Germany, face similar challenges at the sub-national level. At the same time, Louis Brandeis' classic depiction of U.S. states as \"laboratories of democracy\" reminds us that federalism offers opportunities for trying different policy responses and learning from the differing results, especially when federalism has \"experimentalist\" characteristics to encourage feedback and learning. We provide a brief overview of the public and political discourse in Germany, as well as the German federal and state-level policy responses, during the first months of the pandemic and an early, tentative assessment of commonalities, divergence, pathologies, and learning – as well as broader implications for conflict and cooperation in Europe and beyond.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130110098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Beaulieu, C. DiGennaro, E. Stringfellow, Ava Connolly, A. Hamilton, A. Hyder, M. Cerdá, Katherine M. Keyes, Mohammad S. Jalali
OBJECTIVES The rapid increase in opioid overdose and opioid use disorder (OUD) over the past 20 years is a complex problem associated with significant economic costs for healthcare systems and society. Simulation models have been developed to capture and identify ways to manage this complexity and to evaluate the potential costs of different strategies to reduce overdoses and OUD. A review of simulation-based economic evaluations is warranted to fully characterize this set of literature. METHODS A systematic review of simulation-based economic evaluation (SBEE) studies in opioid research was initiated by searches in PubMed, EMBASE, and EbscoHOST. Extraction of a predefined set of items and a quality assessment were performed for each study. RESULTS The screening process resulted in 23 SBEE studies ranging by year of publication from 1999 to 2019. Methodological quality of the cost analyses was moderately high. The most frequently evaluated strategies were methadone and buprenorphine maintenance treatments; the only harm reduction strategy explored was naloxone distribution. These strategies were consistently found to be cost-effective, especially naloxone distribution and methadone maintenance. Prevention strategies were limited to abuse-deterrent opioid formulations. Less than half (39%) of analyses adopted a societal perspective in their estimation of costs and effects from an opioid-related intervention. Prevention strategies and studies' accounting for patient and physician preference, changing costs, or result stratification were largely ignored in these SBEEs. CONCLUSION The review shows consistently favorable cost analysis findings for naloxone distribution strategies and opioid agonist treatments and identifies major gaps for future research.
{"title":"Economic Evaluation in Opioid Modeling: Systematic Review","authors":"E. Beaulieu, C. DiGennaro, E. Stringfellow, Ava Connolly, A. Hamilton, A. Hyder, M. Cerdá, Katherine M. Keyes, Mohammad S. Jalali","doi":"10.2139/ssrn.3587617","DOIUrl":"https://doi.org/10.2139/ssrn.3587617","url":null,"abstract":"OBJECTIVES\u0000The rapid increase in opioid overdose and opioid use disorder (OUD) over the past 20 years is a complex problem associated with significant economic costs for healthcare systems and society. Simulation models have been developed to capture and identify ways to manage this complexity and to evaluate the potential costs of different strategies to reduce overdoses and OUD. A review of simulation-based economic evaluations is warranted to fully characterize this set of literature.\u0000\u0000\u0000METHODS\u0000A systematic review of simulation-based economic evaluation (SBEE) studies in opioid research was initiated by searches in PubMed, EMBASE, and EbscoHOST. Extraction of a predefined set of items and a quality assessment were performed for each study.\u0000\u0000\u0000RESULTS\u0000The screening process resulted in 23 SBEE studies ranging by year of publication from 1999 to 2019. Methodological quality of the cost analyses was moderately high. The most frequently evaluated strategies were methadone and buprenorphine maintenance treatments; the only harm reduction strategy explored was naloxone distribution. These strategies were consistently found to be cost-effective, especially naloxone distribution and methadone maintenance. Prevention strategies were limited to abuse-deterrent opioid formulations. Less than half (39%) of analyses adopted a societal perspective in their estimation of costs and effects from an opioid-related intervention. Prevention strategies and studies' accounting for patient and physician preference, changing costs, or result stratification were largely ignored in these SBEEs.\u0000\u0000\u0000CONCLUSION\u0000The review shows consistently favorable cost analysis findings for naloxone distribution strategies and opioid agonist treatments and identifies major gaps for future research.","PeriodicalId":137980,"journal":{"name":"Public Health eJournal","volume":"489 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116624527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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