@article{ref1,
title="Cost-effectiveness of naloxone kits in secondary schools",
journal="Drug and alcohol dependence",
year="2018",
author="Cipriano, Lauren E. and Zaric, Gregory S.",
volume="192",
number="",
pages="352-361",
abstract="BACKGROUND: We seek to identify conditions under which a plan by the Toronto District School Board (TDSB) to equip high schools with naloxone kits would be cost-effective. <br><br>METHODS: We developed a decision-analytic model to evaluate the costs, benefits, and cost-effectiveness of a school-based naloxone program. We estimated model inputs from the medical literature and used Toronto-specific sources whenever available. We present our results varying both the expected total number of opioid overdoses per year across all 112 TDSB high schools and the effectiveness of a school-based naloxone program in reducing mortality. <br><br>RESULTS: A school naloxone program likely costs less than CAD$50,000 per quality-adjusted life-year gained if the overdose frequency is at least once each year and it reduces opioid poisoning mortality by at least 40% (from 10% to <6.0%) or if the overdose frequency is at least two per year and the program reduces mortality by at least 20% (from 10% to <8.0%). The results are sensitive to the intensity and cost of staff training, the lifetime costs and life-expectancy of overdose survivors, and the probability of an overdose being fatal in the absence of a school naloxone program. <br><br>CONCLUSIONS: School naloxone programs are relatively inexpensive, but that does not ensure that they are a cost-effective use of resources. While potentially cost-effective, if the risk of an overdose in a Toronto high school is low, then other programs aimed at improving the health and wellbeing of students may be better use of limited resources.<br><br>Copyright © 2018 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2018.08.003",
url="http://dx.doi.org/10.1016/j.drugalcdep.2018.08.003"
}