Willingness to pay for drug rehabilitation: Implications for cost recovery

Abstract

Objectives-This study estimates the value that clients place on methadone maintenance and how this value varies with the effectiveness of treatment and availability of case management. We provide the first estimate of the price elasticity of the demand for drug treatment.Methods-We interviewed 241 heroin users who had been referred to, but had not yet entered, methadone maintenance treatment in Baltimore, Maryland. We asked each subject to state a preference among three hypothetical treatment programs that varied across 3 domains: weekly fee paid by the client out-of-pocket ($5 to $100), presence/absence of case management, and time spent heroin-free (3 to 24 months). Each subject was asked to complete 18 orthogonal comparisons. Subsequently each subject was asked if they likely would enroll in their preferred choice among the set of three. We computed the expected willingness to pay (WTP) as the probability of enrollment times the fee considered in each choice considered from a multivariate logistic model that controlled for product attributes. We also estimated the price elasticity of demand.Results-The median expected fee subjects were willing to pay for a program that offered 3 months of heroin-free time was $7.30 per week, rising to $17.11 per week for programs that offered 24 months of heroin-free time. The availability of case management increased median WTP by $5.64 per week. The price elasticity was −0.39 (SE 0.042).Conclusions-Clients will pay more for higher rates of treatment success and for the presence of case management. Clients are willing to pay for drug treatment but the median willingness to pay falls short of the estimated program costs of $82 per week. Thus a combined approach of user fees and subsidization may be the optimal financing strategy for the drug treatment system.

Willingness to pay for opioid agonist treatment among opioid dependent people who inject drugs in Ukraine

“…Among those who are currently prescribed OAT, receiving onsite psychological counseling at OAT sites appeared to be an important factor related to WTP. These findings are consistent with results elsewhere showing that clients would pay more for ancillary services like case management during their addiction treatment (Bishai et al 2008). …”

“…Most prior studies used contingent valuation, indirect, technique to assess WTP for drug misuse treatment (Bishai et al 2008; Borisova & Goodman 2003; Tang et al 2007; Tran 2013; Zarkin et al 2000). Since our study was not originally designed to measure WTP for OAT, we used direct (reveled-preference) method to measure WTP and assessed factors associated with WTP for OAT among groups of PWID in Ukraine with different prior OAT experience.…”

Predictors of opiate agonist treatment retention among injection drug users referred from a needle exchange program

“…Another proxy for treatment motivation and retention may be willingness to pay for treatment. In a study conducted among the participants in this trial, participants indicated they were willing to pay progressively more for treatment the longer they remained heroin-free (Bishai et al, 2007).…”

Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

“…Depression, suicidality, and drug abuse states resulted in rehabilitative costs. [26][27][28] The U.S. cost of illness for HIV was extracted from Walensky et al 29 Cost of provider coverage was dependent on combinations of surgery and HRT. HRT was a fixed cost.…”