Pros And Cons Of Investing In The Drug Treatment - Research Paper Example

Pros And Cons Of Investing In The Drug Treatment Introduction Cost-benefit analysis is normally applicable in economic theory to both the private and public expenditure decisions which need detailed information on the merits of alternative modalities, treatment programs, pharmaco-therapies and behavioral therapies. This follows the fact that the main stakeholders in treatment services provision, insurance companies, local government, managed care systems and federal state have vested interests in information development. Most of the stakeholders opt to fund treatments projects in which net benefits happen to be positive compared to alternative strategies and policies. Patients on the other hand have their expectations on the ways in which drug treatment interventions may effectively lessen symptoms of craving, withdrawal, drug use problem, loss of control, ill health and social dysfunction. This paper is going to conduct a literature review on existing studies and literature on cost-benefit analysis is varying frameworks of decision-making. At the state level, rational budgeting finds treatment funding to be competing with criminal justice, education and transportation in addition to population tax burden. A typical planning approach should be in such as a manner that it should be able to evaluate system support on drug treatment and expansion together with determining the type of treatment that would remain favored improved resources. Decision making in the private sector that have a narrower view point have to make use of cost benefits frameworks so as to attain a rational allocation of resources to the alternatives that can be regarded as most effective. No matter the case, a cost benefit systematic analysis is normally undertaken to come to the decision on whether the private or public investment can be made or for the justification of continued support. In each of the selected studies, costs, benefit and effectiveness will be reviewed. Fundamental to the valuation benefits in the social cost approach which examines negative costs reduction to society engendered by several consequences of dependence and drug use. With this regards, methods on cost of illness offer systematic accounting concepts while estimating the society burden of the total social costs on drug abuse (Holder 23). Cost of illness methods on drug abuse have been key in the estimation of many indirect costs in non markets where disease costs standard burden estimates would only focus on productivity costs and heath care. In order to have the outcomes or benefits of treatment, resources have to be used by the society in interventions on drug treatment. Resources can be consumed in the society through offering services on direct treatment and non-treatment services. This analysis sort out resources which are expended in treatment as well as those offered as transfers. The research is mainly focused on costing of drug abuse consequences from several target populations that can be applicable in studies on cost-benefit. Model Articulation The methodology employed in this study is literature review in chronological order as well as technical development referenced across studies. Depending on the type of study, costs, benefits and benefit cost ratios are presented in the paper followed by a discussion. The preferred decision rule in this study is to come up with all policies that result in positive net benefits. In this case, the ratios on cost benefit are highlighted to facilitate the comparison of different studies where no particular resource decision will be made. Each of the selected studies has some positive assumption on effectiveness whether from the data outcome or outside information. Data/Review A study by Leslie on the benefits associated with social costs of preventing a man with an addiction that had lasted for a year after coming from a treatment (Holder 24). This can be looked at as a conservative study now that there are no benefits that are assigned to the period of in-treatment. The success rates refer to the patient’s proportions who are not heroin addicts after treatment. Such successes are normally obtained from primary program query and not empirical studies. In this study, Leslie obtained the required information from treatment programs on age group data together with additional addiction years estimates. This approach casts in a framework of evaluation which emphasizes on the use of cost benefit analysis in resource allocation as well as strategy development. The study however fails to discuss the performance measures required to monitor the system. This is an important program evaluation and resource management feature. In this study, effectiveness assumptions were adopted which had less scientific basis. The other case involved the study by Maidlow and Berman where the thefts cases were estimated to cost the society over $ 30, 000 every year as patients experienced possible earnings approximated to be about $5084 after the period of treatment. This can however be seen as an over-estimate (Holder 25). Considering the large amount of income gain in this case, the benefit costs ratios are expected to high. However, such high ratios in this case are irrelevant. Thefts are considered as a transfer of resources and not a consumption means unless when the property gets damaged. With this regards, an incorrect concept has been employed in the valuation of benefits. In determining the treatment costs, the foregone income value from work while undergoing treatment was not regarded as a cost. In this study, high discount rates were used going as far as 8 percent while examining the long treatment history of the addicts. Regardless of the shortcomings, the study came up with a positive cost benefit approach that can be emulated. Effectiveness in this case is associated with relapse and dropout rates existing in the therapeutic society as well as the relapse rate maintenance program on methadone. From the study, the therapeutic community observations indicated that approximately 19% of the addicts dropped out within the first 90 days. The assumption was that the remaining addicts stayed until the completion of the program. Four years later, it was also assumed that 37.5% of the remaining study sample were addicts thus a 9.4 % relapse rate was distributed from the 5th year to the 8th year. In methadone maintenance, a 13.5% relapse rate was distributed over the 1st year to the 6th year, with 3% being in the 1st year, and 2% in the 2nd year up to the 6th year. This can be inferred to imply that the study achieved success rates that were very high for the two programs. However, the study did not provide any information on the rates of dropouts among the early dropouts within the 90 days of the study. This study offers a good information grafting from cost-benefit framework to effectiveness studies, on economic decisions that are incorrect on benefit and the appropriate use of mathematical modeling. Another study was conducted by McGothlin and his team on six different treatment strategies used in the United States (Holder 26). Benefits are normally determined as the addicts’ foreign production, theft cost and rising anti-crime measures following the addicts population. This study introduced the declining effectiveness notion now that more patients came in for treatment. As the costs for treatment increased, the treatment benefits reduces, as more patients who were in worse states and need special attention join the treatment programs. However, this effect is not measured empirically. In the methadone maintenance, the strict control recorded benefits per addict reduce to $ 8795 from $ 13980 as the addict treatment years expanded to 125 000 from 100 000. Considering the treatment costs at the same time, they increased to $2500 from $1350. The above figures resulted to the benefit ratio to reduce to 6.6 from 14.55. The net benefits are considered as being positive when the benefit cost is more than one. Clinical trials were also used to capture the incremental effects on benefits and costs. In the economic analysis carried out by Fuji as well as the pathbreaking assignment by Tullock and Becker, measurement approaches and social benefits were identified (Holder 27). Benefits in the two studies were derived from employment income increase as a result of reduction and rehabilitation in the addict crime opportunity loss. In these studies, the costs on addict crime were reviewed while considering capital and labor devoted to criminal activities which may have formed part of the economy as well as costs on additional crime control that were incurred by the government. The crime benefits in this case were estimated as cost reduction agency from addict property crime policing, cost reduction on the enforcement of heroin laws and female prostitution control (Holder 28). The social treatment costs for duration treatment included the loss in employment wages and direct treatment cost. The potential net benefits of about $4700 for every addict each year were estimated. The findings indicate that heroin maintenance failed to receive the labor income that had been increased by $1100 now that the consumption of heroin was observed to reduce the participation of labor forces. Methadone maintenance had different deleterious effects which is a major rationale when it comes to its use. The net benefits were the one reported in place of the benefit cost ratio now that separate cost and benefit estimates were not reported in both the studies. Fuji came to the conclusion that heroin legalization will result in more cost compared to the associated benefits. Conclusion Drug treatment economic analysis needs sophisticated measurement and conceptualization. This follows the fact that services on drug treatment are mostly directed to individual behavior rehabilitation. In addition, the analysis has to have a measure of change in its effectiveness and impact. More so, social cost and benefits have to be estimated. The natural history of treatment and addiction careers have proved to be long thus the need for repeated measures which increase the costs and benefits of the analysis. It is fortunate that benefits are too large that in case of a normal short-run analysis, it is possible to arrive at a benefit –cost ratio that is more than one. In such analyses, it is important that effectiveness measures are established. In drug treatment costing, several approaches can be used. This may include; looking at the treatment cost data of a given episode that has been mostly used. The other approach is adjusting cost to come up with comparisons on different treatment programs. Treatment costs have generally focused on modalities which represent orientations on philosophical treatment and not neutral concepts like outpatient versus inpatient treatment. The studies in this paper were completed from various view points. Some had their focus on statewide planning, others on treatment modalities comparison while other on citywide planning. Some studies go out of their way to change their societal framework through calculating a taxpayers cost. In future, all the studies should have their focus on societal point of view as well as make adjustments using the same point of views in other decision making. While methodological work has already been looked at, more rigorous methods have to be applied to the non-experimental research approaches. Despite the availability of standard cost-benefit analysis approaches, more work is required as well as the new approaches being expanded. This paper uncovered notable areas of omission. There exist no cost-benefit studies conducted on adolescents and very few on women treatment. Cost-benefit analyses on treatment services that are comprehensive have not been exploited yet this is a major issue to drug treatment. Following the introduction of modern treatment guidelines that have been developed under the Center for Substances Abuse Treatment sponsorship, it remains imperative to evaluate the implications of cost benefits. One of the main problems facing health economies is the manner in which cost benefit analysis and heath changes values remain the operational tools which develop and use monetary measures in their estimations of such value changes. Empirical and theoretical research have to proceed on several approaches in the assessment of health change values in the society and interventions on drug treatment remain a critical focus for future research. Work Cited Holder HD. Cost benefits of substance abuse treatment: an overview of results from alcohol and drug abuse. J. Mental Health Policy Econ. 1998; 1(1): 23-29 Read More