Estimated cost of comprehensive syringe service program in the United States

Abstract

Objective To estimate the cost of establishing and operating a comprehensive syringe service program (SSP) free to clients in the United States. Methods We identified the major cost components of a comprehensive SSP: (one-time start-up cost, and annual costs associated with personnel, operations, and prevention/medical services) and estimated the anticipated total costs (2016 US dollars) based on program size (number of clients served each year) and geographic location of the service (rural, suburban, and urban). Results The estimated costs ranged from $0.4 million for a small rural SSP (serving 250 clients) to $1.9 million for a large urban SSP (serving 2,500 clients), of which 1.6% and 0.8% is the start-up cost of a small rural and large urban SSP, respectively. Cost per syringe distributed varied from $3 (small urban SSP) to $1 (large rural SSP), and cost per client per year varied from $2000 (small urban SSP) to $700 (large rural SSP). Conclusions Estimates of the cost of SSPs in the United States vary by number of clients served and geographic location of service. Accurate costing can be useful for planning programs, developing policy, allocating funds for establishing and supporting SSPs, and providing data for economic evaluation of SSPs.

Hospital admissions and mortality due to complications of injection drug use in two hospitals in Regina, Canada: retrospective chart review

“…SSTIs were also the admission diagnosis most strongly associated with risk of death, at an odds ratio of 12.42. The cost of running a NSP is estimated to be $700 to $2000 USD per client per year, which compares very favorably with the downstream costs of IDU hospitalizations we illustrate in this study [ 44 ].…”

Cost-effectiveness of syringe service programs, medications for opioid use disorder, and combination programs in hepatitis C harm reduction among opioid injection drug users: a public payer perspective using a decision tree

“…Cost data were collected from public data sources, primary literature sources, and recently published cost-effectiveness studies (Table 2). [27][28][29][30][31][32][33][34] The per-person-per annum cost of SSP and MOUD were obtained from literature sources. [27][28][29] Results of the base-case costeffectiveness analysis are shown in Table 3.…”

Mobilizing pharmacists to address the opioid crisis: A joint opinion of the ambulatory care and adult medicine practice and research networks of the American College of Clinical Pharmacy

“…62 SSP are typically community-based prevention programs providing access to sterile syringes, drug preparation equipment, and safe disposal at no cost to PWID. 63,64 The range of services provided through SSPs may be limited to only sterile syringe access or include a variety of additional harm reduction and OUD services. These programs have long been recognized as a means for decreasing transmission of HIV, HBV, and HCV.…”

“…Also, SSPs are increasingly recognized as an opportunity to engage patients with SUDs who otherwise may not be ready to participate in treatment discussions. 63,65 The US Surgeon General supports SSPs as part of a set of comprehensive morbidity and mortality-reducing interventions for the opioid crisis. 68 In addition to syringe access, many PWID are unaware of their eligibility for pre-exposure prophylaxis, which has also been shown to significantly reduce HIV transmission.…”

“…Importantly, these data can stimulate swift changes to state syringe laws, such as the passage of Florida's Infectious Disease Elimination Act in 2019 following these pilot data. Also, SSPs are increasingly recognized as an opportunity to engage patients with SUDs who otherwise may not be ready to participate in treatment discussions 63,65 . The US Surgeon General supports SSPs as part of a set of comprehensive morbidity and mortality‐reducing interventions for the opioid crisis 68 .…”