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Cost Effectiveness of Streetworks’ Needle Exchange Program of Edmonton

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Abstract

Objective: To conduct a cost-effectiveness analysis of the Edmonton Streetworks needle exchange program, in terms of the additional cost per HIV infection averted. The main outcome measures were needle use with and without Streetworks, HIV cases averted, and program costs.

Method: We conducted interviews and HIV saliva tests on a sample of street-involved intravenous drug users (IDU) who are regular Streetworks’ clients. Outcomes were used in a cost-effectiveness model.

Results: It is projected that the program has a cost-effectiveness of $9,500 (Canadian) per HIV infection delayed for one year.

Conclusions: The discounted cost per case averted is less than the cost of a case of AIDS. Continuing the program is a dominant strategy.

Résumé

Objectif: effectuer une analyse coût-efficacité du programme d’échange de seringues Edmonton Streetworks pour déterminer le coût supplémentaire pour chaque infection à VIH évitée. Les principales mesures des résultats ont été l’utilisation des seringues avec et sans Streetworks, les cas d’infection par le VIH évités, et les coûts du programme.

Méthode: on a mené des entrevues et réalisé des tests de dépistage du VIH dans la salive auprès d’un échantillon d’usagers de drogues injectables (UDI) de la rue qui sont des clients réguliers de Streetwork. Les résultats ont ensuite servis à un modèle d’analyse coût-efficacité.

Résultats: l’analyse coût-efficacité situe à 9 500 $ (CAN) le coût par cas d’infection à VIH différée d’un an.

Conclusions: le coût actualisé de chaque cas évité est inférieur au coût global d’un cas de sida. Le maintien du programme constitue une stratégie essentielle.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Alberta, Canada

    Philip Jacobs DPhil, CMA & L. Duncan Saunders MB, PhD

  2. Institute of Pharmaco-Economics, #710, 10665 Jasper Avenue, Edmonton, AB, T5J 3S9, Canada

    Philip Jacobs DPhil, CMA

  3. Department of Educational Psychology, University of Alberta, Canada

    Peter Glider PhD

  4. Streetworks, Inc., Edmonton, Alberta, Canada

    Marliss Taylor RN, BScN, NP

  5. Department of Medicine, University of Alberta, Canada

    Stanley Houston MD, FRCPC

  6. Canadian Policy Research Networks, Inc., Ottawa, Ontario, Canada

    Terry Albert MHSA

Authors
  1. Philip Jacobs DPhil, CMA
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  2. Peter Glider PhD
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  3. Marliss Taylor RN, BScN, NP
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  4. Stanley Houston MD, FRCPC
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  5. L. Duncan Saunders MB, PhD
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  6. Terry Albert MHSA
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Corresponding author

Correspondence to Philip Jacobs DPhil, CMA.

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Jacobs, P., Glider, P., Taylor, M. et al. Cost Effectiveness of Streetworks’ Needle Exchange Program of Edmonton. Can J Public Health 90, 168–171 (1999). https://doi.org/10.1007/BF03404500

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