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

Xu X, Yonkers KA, and Ruger JP. “Costs of a Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy Versus Brief Advice for Pregnant Substance Users,” PLoS One, 2014; 9(4): e95264.

10 Pages Posted: 17 Oct 2014

See all articles by Xiao Xu

Xiao Xu

Yale School of Medicine

Kimberly A. Yonkers

Yale University - Department of Psychiatry

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine

Date Written: April 2014

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

Xu, Xiao and Yonkers, Kimberly A. and Prah Ruger, Jennifer, Costs of a Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy versus Brief Advice for Pregnant Substance Users (April 2014). Xu X, Yonkers KA, and Ruger JP. “Costs of a Motivational Enhancement Therapy Coupled with Cognitive Behavioral Therapy Versus Brief Advice for Pregnant Substance Users,” PLoS One, 2014; 9(4): e95264., Available at SSRN: https://ssrn.com/abstract=2510899

Xiao Xu

Yale School of Medicine ( email )

310 Cedar Street
LSOG 205B, PO Box 208063
New Haven, CT 06520
United States

Kimberly A. Yonkers

Yale University - Department of Psychiatry ( email )

New Haven, CT 06520
United States

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

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