Economic Evaluation Comparing CCT With MMT in Hai Phong City, Vietnam

Completed

• Conditions: Heroin Dependence
• Interventions: Other: MMT; Other: CCT

• Registration Number: NCT03071315
• Lead Sponsor: The University of New South Wales

Brief Summary

The study compared the effectiveness and cost-effectiveness of two dominant heroin dependence treatment approaches: center-based compulsory rehabilitation (CCT) and community-based voluntary methadone treatment (MMT) in Hai Phong City, Vietnam. The design was a combined retrospective and prospective, non-randomized cohort over three years (with data at five time-points). The study was conducted between 2012 and 2015, involving 208 CCT participants and 384 MMT participants with heroin dependence.

Detailed Description

The study compared the effectiveness and cost-effectiveness of two dominant heroin dependence treatment approaches: center-based compulsory rehabilitation (CCT) and community-based voluntary methadone treatment (MMT) in Hai Phong City, Vietnam. CCT centers are institutions in which people who use drugs are confined for two years. MMT has been internationally recognized as an efficacious treatment for heroin dependence and was introduced in Vietnam in 2008.

The design was combined retrospective and prospective, non-randomized cohort over three years (with data at five time-points). The study was conducted between 2012 and 2014, involving 208 CCT participants (of which 80% were followed up) and 384 MMT participants (of which 78% were followed up) with heroin dependence. The five time-points were: baseline, two years after treatment commencement, then three months, six months and 12 months after the initial two years. The study combined primary data and secondary data to assess the effectiveness of the two treatment modalities. The economic component measured the costs of the two treatment modalities to compare cost-effectiveness outcomes.

The study had two primary outcomes: self-reported heroin abstinence (confirmed by urine drug screening) and self-reported drug-free days (DFDs). DFDs was reported in two different time-frames. DFDs in the preceding 30 days was used for effectiveness comparison and DFDs over three years was used for the cost-effectiveness comparison. The study has four secondary outcomes: illegal behaviors, overdose, blood-borne virus (BBV) risk behaviors, and monthly drug spending).

Mixed effects regression models were used to analyze the effectiveness data and non-parametric bootstrapping methods were used to estimate cost-effectiveness. The time-frame for the cost-effectiveness analysis was three years.

Study Timeline

• Study Start: 2013-01-20
• Primary Completion: 2015-01-30
• Study Completion: 2015-01-30
• Study First Submitted: 2017-02-28
• Study First Submitted QC: 2017-02-28
• Status Verified: 2017-03
• Study First Posted: 2017-03-06
• Last Update Submitted: 2017-03-09
• Last Update Posted: 2017-03-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 522

Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
MMT participants	MMT	Methadone maintenance treatment (MMT) participants who have been receiving MMT treatment. In Hai Phong City, during the period of this study, voluntary MMT was provided in the community free for people who were assessed as dependent on heroin.
CCT participants	CCT	Center-based compulsory treatment (CCT) participants who were placed into compulsory treatment centers for two years for a range of punitive treatment such as education, moral teaching, labor work. Very basic health care is provided in the CCT centers.

Primary Outcome Measures

Name	Time	Method
Heroin abstinence	Preceding 3 months and 30 days	Free from heroin use (self-reported), confirmed by urine drug screening on interview day.

Secondary Outcome Measures

Name	Time	Method
Drug-use related blood-borne virus (BBV) risk behaviors	Preceding 3 months and 30 days	Drug-use related blood-borne virus (BBV) risk behaviors
Drug-free days	Preceding 3 months and 30 days	Days without use of any illicit drugs (self-report)
Drug-use related illegal behaviors	Preceding 3 months and 30 days	Drug-use related illegal behaviors
Overdose incidents	Preceding 3 months and 30 days	Overdose incidents
Monthly drug spending	Preceding 3 months and 30 days	Monthly drug spending

Trial Locations

Locations (1)

Study site in Vietnam; 🇻🇳 Hai Phong, Vietnam