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Published Online: 19 October 2023

Budget Impact Tool for Implementing Contingency Management for Co-occurring Alcohol Use Disorders and Serious Mental Illness

Thanh T. Lu, Ph.D. [email protected], Sara C. Parent, N.D., Naomi Chaytor, Ph.D., A.B.P.P., Solmaz Amiri, D.Des., Katharine Palmer, M.P.H., Sterling McPherson, Ph.D., Julianne Jett, Ph.D., Richard Ries, M.D., Michael G. McDonell, Ph.D., and Sean M. Murphy, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 4
https://doi.org/10.1176/appi.ps.20220547
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Abstract

Objective:

Contingency management (CM) is a behavioral intervention in which tangible incentives are provided to patients when they achieve a desired behavior (e.g., reducing or abstaining from alcohol use). The authors sought to describe the resource requirements and associated costs of various CM versions (usual, high magnitude, and shaping) tailored to a high-risk population with co-occurring serious mental illness and severe alcohol use disorder.

Methods:

A microcosting analysis was conducted to identify the resource requirements of the different CM versions. This approach included semistructured interviews with site investigators, who also staffed the intervention. The resource costing method—multiplying the number of units of each resource utilized by its respective unit cost—was used to value the resources from a provider’s perspective. All cost estimates were calculated in 2021 U.S. dollars.

Results:

The cost of setting up a CM program was $6,038 per site. Assuming full capacity and 56% of urine samples meeting the requirement for receipt of the CM incentive, the average cost of 16 weeks of usual and shaping CM treatments was $1,119–$1,136 and of high-magnitude CM was $1,848–$1,865 per participant.

Conclusions:

A customizable tool was created to estimate the costs associated with various levels of treatment success and CM design features. After the trial, the tool will be updated and used to finalize per-participant cost for incorporation into a comprehensive economic evaluation. This costing tool will help a growing number of treatment providers who are interested in implementing CM with budgeting for and sustaining CM in their practices.

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Supplementary Material

File (appi.ps.20220547.ds001.pdf)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 4 • April 01, 2024
Pages: 326 - 332
PubMed: 37855102

History

Received: 25 October 2022
Revision received: 6 June 2023
Revision received: 2 August 2023
Accepted: 24 August 2023
Published online: 19 October 2023
Published in print: April 01, 2024

Keywords

  1. Alcoholism
  2. Economics
  3. Contingency management
  4. Behavior therapy
  5. Budget impact tool

Authors

Affiliations

Thanh T. Lu, Ph.D. [email protected]
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Sara C. Parent, N.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Naomi Chaytor, Ph.D., A.B.P.P.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Solmaz Amiri, D.Des.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Katharine Palmer, M.P.H.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Sterling McPherson, Ph.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Julianne Jett, Ph.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Richard Ries, M.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Michael G. McDonell, Ph.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Sean M. Murphy, Ph.D.
Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina (Lu); Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane (Parent, Chaytor, Palmer, McPherson, Jett, McDonell); Institute for Research and Education to Advance Community Health, Washington State University, Seattle (Amiri); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (Ries); Department of Population Health Sciences, Weill Cornell Medical College, New York City (Murphy).
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Notes

Send correspondence to Dr. Lu ([email protected]).

Competing Interests

Dr. Murphy served on an advisory board panel for Indivior. The other authors report no financial relationships with commercial interests.

Funding Information

This research was supported by the National Institute on Alcohol Abuse and Alcoholism (R01 AA-020248) and the National Institute on Drug Abuse (P30 DA-040500).

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