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Study finds Canada's supervised injection facility cost-effective

November 18, 2008

Results show $14 million in savings over 10 years and huge health gains

Canada's only supervised injection facility is extending lives and saving the health-care system millions of dollars, a new study shows.

In analyzing the cost-effectiveness of Vancouver-based Insite, a safe injection facility in a downtown neighbourhood where about 5,000 injection drug users live, researchers found $14 million in savings and health gains of 920 life-years over 10 years.

Published in the November 18 edition of Canadian Medical Association Journal, the study compares the costs of operating Insite to savings from reduced needle sharing, decreased HIV and Hepatitis C virus infections and increased referrals for methadone treatment.

Entitled, "Cost-Effectiveness of the Vancouver Safe Injection Facility," the study is authored by Dr. Ahmed Bayoumi of St. Michael's Hospital and the University of Toronto and Greg Zaric, an associate professor in the health sector MBA program from Richard Ivey School of Business and Schulich School of Medicine & Dentistry at The University of Western Ontario.

For the study, the researchers used computer simulation to estimate the number of HIV and Hepatitis C cases that could be prevented through the facility compared to sites using other intervention methods, such as needle-exchange programs, only.

Results show Insite improves health and saves the health-care system money, even under conservative estimates of efficacy. And that's without considering the additional potential health benefits such as decreased drug overdose, reduced transmission of Hepatitis B and fewer incidences of soft-tissue infections and other side-effects from unhygienic injection.

"If the cost-effectiveness of Insite was evaluated using the same standards as are commonly applied to other medical interventions, it would be considered very cost effective," said Zaric, Canada Research Chair in Health Care Management Science. "When we also consider the health effects of increased use of safe injection practices, the savings are even greater."

Although such findings are encouraging, Zaric cautions against extrapolating to other cities, such as Toronto and Ottawa, where similar facilities are proposed, because the specific situations may differ.

Supervised injection facilities already exist in more than two dozen cities in Europe and Australia.

University of Western Ontario