Margarida Borges1,2,3, Miguel Gouveia1,2,3, Francesca Fiorentino1,2,3, Gonçalo Jesus1,2,3, Maria Cary1,2,3, José Pedro Guerreiro1,2,3, Suzete Costa1,2,3, António Vaz Carneiro1,2,3. 1. Faculdade de Medicina (Borges, Fiorentino, Jesus, Vaz Carneiro), Universidade de Lisboa. 2. Laboratório de Farmacologia Clínica e Terapêutica, Unidade de Farmacologia Clínica, Centro Hospitalar Lisboa Central EPE (Borges). 3. Católica Lisbon School of Business and Economics, Universidade Católica Portuguesa (Gouveia); the Centro de Estudos e Avaliação em Saúde (CEFAR), Associação Nacional das Farmácias, Lisbon, Portugal (Cary, Guerreiro) and Institute for Evidence-Based Health (ISBE), Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal (Costa).
Abstract
BACKGROUND: Needle-exchange programs (NEPs) reduce infections in people who inject drugs. This study assesses the impact community pharmacies have had in the Needle-Exchange Program in Portugal since 2015. METHODS: Health gains were measured by the number of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections averted, which were estimated, in each scenario, based on a standard model in the literature, calibrated to national data. The costs per infection were taken from national literature; costs of manufacturing, logistics and incineration of injection materials were also considered. The results were presented as net costs (i.e., incremental costs of the program with community pharmacies less the costs of additional infections avoided). RESULTS: Considering a 5-year horizon, the Needle Exchange Program with community pharmacies would account for a 6.8% (n = 25) and a 6.5% reduction (n = 22) of HCV and HIV infections, respectively. The present value of net savings generated by the participation of community pharmacies in the program was estimated at €2,073,347. The average discounted net benefit per syringe exchanged is €3.01, already taking into account a payment to community pharmacies per needle exchanged. INTERPRETATION: We estimate that the participation of community pharmacies in the Needle Exchange Program will lead to a reduction of HIV and HCV infections and will generate over €2 million in savings for the health system. CONCLUSIONS: The intervention is estimated to generate better health outcomes at lower costs, contributing to improving the efficiency of the public health system in Portugal.
BACKGROUND: Needle-exchange programs (NEPs) reduce infections in people who inject drugs. This study assesses the impact community pharmacies have had in the Needle-Exchange Program in Portugal since 2015. METHODS: Health gains were measured by the number of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections averted, which were estimated, in each scenario, based on a standard model in the literature, calibrated to national data. The costs per infection were taken from national literature; costs of manufacturing, logistics and incineration of injection materials were also considered. The results were presented as net costs (i.e., incremental costs of the program with community pharmacies less the costs of additional infections avoided). RESULTS: Considering a 5-year horizon, the Needle Exchange Program with community pharmacies would account for a 6.8% (n = 25) and a 6.5% reduction (n = 22) of HCV and HIV infections, respectively. The present value of net savings generated by the participation of community pharmacies in the program was estimated at €2,073,347. The average discounted net benefit per syringe exchanged is €3.01, already taking into account a payment to community pharmacies per needle exchanged. INTERPRETATION: We estimate that the participation of community pharmacies in the Needle Exchange Program will lead to a reduction of HIV and HCV infections and will generate over €2 million in savings for the health system. CONCLUSIONS: The intervention is estimated to generate better health outcomes at lower costs, contributing to improving the efficiency of the public health system in Portugal.
Authors: Norah Palmateer; Jo Kimber; Matthew Hickman; Sharon Hutchinson; Tim Rhodes; David Goldberg Journal: Addiction Date: 2010-03-02 Impact factor: 6.526
Authors: H Razavi; I Waked; C Sarrazin; R P Myers; R Idilman; F Calinas; W Vogel; M C Mendes Correa; C Hézode; P Lázaro; U Akarca; S Aleman; I Balık; T Berg; F Bihl; M Bilodeau; A J Blasco; C E Brandão Mello; P Bruggmann; M Buti; J L Calleja; H Cheinquer; P B Christensen; M Clausen; H S M Coelho; M E Cramp; G J Dore; W Doss; A S Duberg; M H El-Sayed; G Ergör; G Esmat; K Falconer; J Félix; M L G Ferraz; P R Ferreira; S Frankova; J García-Samaniego; J Gerstoft; J A Giria; F L Gonçales; E Gower; M Gschwantler; M Guimarães Pessôa; S J Hindman; H Hofer; P Husa; M Kåberg; K D E Kaita; A Kautz; S Kaymakoglu; M Krajden; H Krarup; W Laleman; D Lavanchy; R T Marinho; P Marotta; S Mauss; C Moreno; K Murphy; F Negro; V Nemecek; N Örmeci; A L H Øvrehus; J Parkes; K Pasini; K M Peltekian; A Ramji; N Reis; S K Roberts; W M Rosenberg; F Roudot-Thoraval; S D Ryder; R Sarmento-Castro; D Semela; M Sherman; G E Shiha; W Sievert; J Sperl; P Stärkel; R E Stauber; A J Thompson; P Urbanek; P Van Damme; I van Thiel; H Van Vlierberghe; D Vandijck; H Wedemeyer; N Weis; J Wiegand; A Yosry; A Zekry; M Cornberg; B Müllhaupt; C Estes Journal: J Viral Hepat Date: 2014-05 Impact factor: 3.728
Authors: P Bruggmann; T Berg; A L H Øvrehus; C Moreno; C E Brandão Mello; F Roudot-Thoraval; R T Marinho; M Sherman; S D Ryder; J Sperl; U Akarca; I Balık; F Bihl; M Bilodeau; A J Blasco; M Buti; F Calinas; J L Calleja; H Cheinquer; P B Christensen; M Clausen; H S M Coelho; M Cornberg; M E Cramp; G J Dore; W Doss; A S Duberg; M H El-Sayed; G Ergör; G Esmat; C Estes; K Falconer; J Félix; M L G Ferraz; P R Ferreira; S Frankova; J García-Samaniego; J Gerstoft; J A Giria; F L Gonçales; E Gower; M Gschwantler; M Guimarães Pessôa; C Hézode; H Hofer; P Husa; R Idilman; M Kåberg; K D E Kaita; A Kautz; S Kaymakoglu; M Krajden; H Krarup; W Laleman; D Lavanchy; P Lázaro; P Marotta; S Mauss; M C Mendes Correa; B Müllhaupt; R P Myers; F Negro; V Nemecek; N Örmeci; J Parkes; K M Peltekian; A Ramji; H Razavi; N Reis; S K Roberts; W M Rosenberg; R Sarmento-Castro; C Sarrazin; D Semela; G E Shiha; W Sievert; P Stärkel; R E Stauber; A J Thompson; P Urbanek; I van Thiel; H Van Vlierberghe; D Vandijck; W Vogel; I Waked; H Wedemeyer; N Weis; J Wiegand; A Yosry; A Zekry; P Van Damme; S Aleman; S J Hindman Journal: J Viral Hepat Date: 2014-05 Impact factor: 3.728
Authors: Jisoo A Kwon; Jonathan Anderson; Cliff C Kerr; Hla-Hla Thein; Lei Zhang; Jenny Iversen; Gregory J Dore; John M Kaldor; Matthew G Law; Lisa Maher; David P Wilson Journal: AIDS Date: 2012-11-13 Impact factor: 4.177