The Costs of Implementing Screening and Brief Intervention for Illicit Drug Use

The costs of implementing illicit drug use screening and brief intervention (SBI) in primary care are not known. Researchers used data from a randomized controlled trial and an existing local clinical program of illicit drug SBI to estimate per-patient direct delivery (e.g., labor) and service support (e.g., start-up, clinical supervision, booster training, information technology) costs for: screening, brief negotiated interview (BNI; 10–15 minute session), and motivational interview (MI; 30–45 minute session with option of a second session).

• Estimated average per-patient time and costs for direct delivery: screening, 2.2 minutes, $2.30; BNI, 14.4 minutes, $6.16; MI, 45 minutes, $29.61.
  • Labor accounted for 55% of screening, 77% of BNI, and 87% of MI direct delivery costs.
• Estimated average per-patient costs for service support: screening, $13.31; BNI, $32.77; MI, $222.65.
• Estimated average per-patient total (direct delivery plus service support) costs: Screening, $15.61; BNI, $38.94; MI, $252.26.

Comments:

This intelligent analysis indicates that costs for implementing SBI for illicit drug use in primary care are similar to those previously reported for alcohol SBI. The majority of costs were for clinical support services and not direct delivery of the services. Whether the clinical support services costs would decrease over time at a clinical site is not known. However, the larger and more important question is whether the clinical benefit of SBI for illicit drug use is worth the estimated cost. This analysis cannot answer that question because the clinical trial that served as its basis did not show a benefit of SBI for illicit drug use.

Kevin L. Kraemer, MD, MSc

Reference:

Zarkin G, Bray J, Hinde J, Saitz R. Costs of screening and brief intervention for illicit drug use in primary care settings. J Stud Alcohol Drugs. 2015;76(2):222–228.