Table 3.

Summary of 6 economic evaluations of drug abuse treatment programs for pregnant women

Characteristics		Svikis et al (1997)	Svikis et al (1998)	Jansson et al (1996)	Daley et al (2000)	Daley et al (2001)	Daley et al (2005)
Method	Analysis type	CEA	CEA	CEA	CBA	CEA	CEA
	Model type	Nonrandomized case-control	Nonrandomized case-control	Nonrandomized case-control	Multivariate regression	Multivariate regression	Multivariate regression
Framing	Setting and population	Women with medical or psychosocial problems from drug use	Drug abusing women enrolled in urban, hospital-based obstetric clinic	Pregnant, drug-using women	Medicaid-eligible pregnant women receiving treatment in MA between 1992–1997	Medicaid-eligible pregnant women receiving treatment in MA between 1992–1997	Medicaid-eligible pregnant women receiving treatment in MA between 1992–1996
	Intervention (comparator)	1 week residential care followed by intensive outpatient services through labor/delivery No treatment	Weekly substance abuse support group No treatment	Multidisciplinary CAPa program with individual and group counseling No treatment	Methadone tx only Residential tx only Outpatient tx only Residential/outpatient tx Detoxification only	Methadone tx only Residential tx only Outpatient tx only Residential/outpatient tx Detoxification only	Methadone tx only Residential tx only Outpatient tx only Residential/outpatient tx Detoxification only
	Perspective	Not reported	Not reported	Not reported	Taxpayers	Payer	Patient
	Time horizon	Birth and end of NICUb stay	3 weeks after delivery	1 year after birth	1 year	Pregnancy and 6 months postpartum	Follow-up typically 6 months post-intake
Effects	Main outcome and benefits measures	Need for and duration of NICU services	Maternal and neonatal outcomes (birth weights, 1min Apgar scores)	Need for and duration of NICU services	Time and costs of crime and of using criminal justice system	Infant birth weight	Quality of life index (QOLI)
Cost	Cost analysis (cost components)	Drug treatment costs NICU costs	Short-term infant and maternal medical care costs	NICU costs	Drug treatment costs Cost of crime (victimization costs, criminal justice costs)	Health care expenditure during pregnancy through 6 months postpartum	Drug treatment costs
	Base year (costs)	1991–1992	1989–1990	Not available	1998	1992–1997	1992–1996
	Source (costs)	NICU rates, billing records	Hospital records	Hospital and program records	Bureau of Justice Statistics, National Crime Victimization Survey, National Police Budget	Addiction Severity Index, treatment records, Medicaid claims	Fiscal records from MA Department of Public Health Bureau of Substance Abuse Services
Results	Summary results	Average net savings of $4,644 per mother/infant pair in treatment	Support group attendance decreased costs by $1,000 (maternal) and >$1,500 (infant/neonatal) and increased birth weight and 1min Apgar scores	Cost savings of nearly $5,000 per mother/infant pair	Net benefit ranged from $32,772 for residential only to $3,072 for detoxification	Compared to detoxification group, outpatient programs cost an additional $1,788 to increase birth weight by 139 grams and residential/outpatient tx cost an additional $17,211 to increase birth weight by 190g	Costs per QOLI ranged from $14,912 for detoxification to $44,291 for residential/outpatient

^aCenter for Addiction and Pregnancy (CAP)

^bNeonatal intensive care unit (NICU)