# Cost Effectiveness of Interventions to Reduce Morbidity from Opioid Dependency

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2022 · —

## Abstract

Project Background: Over the past decade, opioid use and injection drug use, particularly heroin injection,
have increased across most US demographic groups, making opioid-use-related mortality and morbidity a
public health crisis both for Veterans and non-Veterans. Morbidity from opioid use is broad, including
acquisition of HIV and HCV, which spread efficiently through the transfer of blood in shared injecting
equipment. Interventions to prevent morbidity from opioid use disorder include opioid agonist therapy,
psychosocial interventions, HIV pre-exposure prophylaxis, clean needle programs, and enhanced testing for
blood-borne diseases, but the cost effectiveness of these interventions in VA has not been determined. In prior
work, we have evaluated the cost effectiveness of interventions to prevent HIV for people who inject drugs in
non-Veteran populations and found some to be very expensive.
Project Objectives: This study will assess health outcomes, costs, cost effectiveness, and budget impact of
interventions to reduce the morbidity and mortality associated with opioid use disorder. The analysis will
assess the cost effectiveness of interventions used individually or in combination when applied to populations
of Veterans.
Project Methods: To accomplish our objectives we will develop cost effectiveness models that assess health
outcomes, cost, cost effectiveness, and budget impact of interventions to reduce morbidity and mortality from
opioid use disorders. We will extend models that we have developed previously to reflect the costs and
population characteristics of Veterans. Our analyses will include opioid agonist therapy, psychosocial
interventions, HIV pre-exposure prophylaxis, use of naloxone, intensive screening for HIV and HCV, and other
opioid use disorder treatments. To develop parameter estimates of effectiveness and harms of interventions,
we will systematically review studies of interventions and assess study design, study quality, consistency, and
applicability to Veteran populations. We will also assess whether comorbid conditions and receipt of social
services affects the effectiveness of opioid use disorder treatment. To estimate costs of interventions we will
use both literature-based estimates for interventions that VA has not provided and VA costs where available
and appropriate.
Our analyses will estimate both cost effectiveness and budget impact. Cost effectiveness is determined by the
incremental benefit of an intervention compared to the next best alternative intervention divided by the
incremental costs. Single interventions are unlikely to provide the same degree of benefit as combined
interventions. However, how cost effectiveness varies for multiple interventions requires careful analyses
because interventions may be synergistic or duplicative. Our analyses will account for these
interdependencies. Our analyses will estimate deaths averted, adverse events from treatment, life years
gained, quality-adjusted life year...

## Key facts

- **NIH application ID:** 10308559
- **Project number:** 5I01HX002457-04
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** DOUGLAS K OWENS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-04-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10308559

## Citation

> US National Institutes of Health, RePORTER application 10308559, Cost Effectiveness of Interventions to Reduce Morbidity from Opioid Dependency (5I01HX002457-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10308559. Licensed CC0.

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