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Costs of a Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy versus Brief Advice for Pregnant Substance Users

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  • Xiao Xu
  • Kimberly A Yonkers
  • Jennifer P Ruger

Abstract

Objectives: To determine and compare costs of a nurse-administered behavioral intervention for pregnant substance users that integrated motivational enhancement therapy with cognitive behavioral therapy (MET-CBT) to brief advice (BA) administered by an obstetrical provider. Both interventions were provided concurrent with prenatal care. Methods: We conducted a micro-costing study that prospectively collected detailed resource utilization and unit cost data for each of the two intervention arms (MET-CBT and BA) within the context of a randomized controlled trial. A three-step approach for identifying, measuring and valuing resource utilization was used. All cost estimates were inflation adjusted to 2011 U.S. dollars. Results: A total of 82 participants received the MET-CBT intervention and 86 participants received BA. From the societal perspective, the total cost (including participants’ time cost) of the MET-CBT intervention was $120,483 or $1,469 per participant. In contrast, the total cost of the BA intervention was $27,199 or $316 per participant. Personnel costs (nurse therapists and obstetric providers) for delivering the intervention sessions and supervising the program composed the largest share of the MET-CBT intervention costs. Program set up costs, especially intervention material design and training costs, also contributed substantially to the overall cost. Conclusions: Implementation of an MET-CBT program to promote drug abstinence in pregnant women is associated with modest costs. Future cost effectiveness and cost benefit analyses integrating costs with outcomes and benefits data will enable a more comprehensive understanding of the intervention in improving the care of substance abusing pregnant women.

Suggested Citation

  • Xiao Xu & Kimberly A Yonkers & Jennifer P Ruger, 2014. "Costs of a Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy versus Brief Advice for Pregnant Substance Users," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-10, April.
  • Handle: RePEc:plo:pone00:0095264
    DOI: 10.1371/journal.pone.0095264
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    1. Russell, M. & Martier, S.S. & Sokol, R.J. & Mudar, P. & Jacobson, S. & Jacobson, J., 1996. "Detecting risk drinking during pregnancy: A comparison of four screening questionnaires," American Journal of Public Health, American Public Health Association, vol. 86(10), pages 1435-1439.
    2. S. Tan & F. Rutten & B. Ineveld & W. Redekop & L. Hakkaart-van Roijen, 2009. "Comparing methodologies for the cost estimation of hospital services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(1), pages 39-45, February.
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