Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
Mary Lou Chatterton
Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
Joahna Kevin Perez
Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
Oxana Chiotelis
Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
Huong Ngoc Quynh Tran
Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
Marufa Sultana
Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
Natasha Hall
Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
Yong Yi Lee
Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
Cath Chapman
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
Nicola Newton
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
Tim Slade
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
Matt Sunderland
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
Maree Teesson
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
Cathrine Mihalopoulos
Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; and Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
Background Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear. Aims This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use. Method Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist. Results Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost–benefit studies reported cost-savings. One cost-effectiveness and two cost–utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds. Conclusions There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics (‘the Network System to Prevent Doctor-Shopping for Narcotics’) show promising cost-effectiveness and warrant consideration.
