Economic Issues & Substitution Treatment (Slovak Perspective)

1. Economic Issues & Substitution Treatment(Slovak Perspective) Lubomir Okruhlica, MD, PhD Seminar on Substitution Treatment in V4 Bratislava, March 13.-14., 2003

11. Demand for Treatment Due to Use of Opioid Drugs (Slovakia 2002)

12. Estimated Number of People with Opiate Dependence Expert estimations calculated from UZIS survey in population, 2000. Slovakia: app. 3,500 - 8,000 with opiate dependence Bratislava: app. 3,500 heroin users app. 1,200 - 1,500 with opiate depend.

13. Estimations • If we apply “principle of thirds”, based on previous epidemiological findings and the out-comes of follow-up, estimated No. Of people who might benefit from ST is as it follows: • app. 1,700 - 4,000 in Slovakia • app. 500 - 700 in Bratislava city (currently about 450)

14. Costs for Treatment(based on CTTD Bratislava No.)in 2000 • Drug-Free Medical In-Patient: - 1 day: app. Euro 40 - 24 days average: Euro 720 - 90 days full therapy.: Euro 2,700 • Methadone Maintenance Treatment: - 1 day: app. Euro 1.75 - 1 year: Euro 638.75 Note: based on average exchange rates Euro/Skk. In 2000

15. Costs for Treatment(based on CTTD Bratislava No.)in 2001 • Drug-Free Medical In-Patient: - 1 day: Euro 31 - 90 days full therapy.: Euro 2,830 • Methadone Maintenance Treatment: - 1 day: Euro 2.50 - 1 year: Euro 918 Note: based on average exchange rates Euro/Skk. In 2001

16. Costs for Treatment(based on CTTD Bratislava No.) • Buprenorphine Substitution Treatment: - 1 day: app. Euro 6.20 - 1 year: app. Euro 2,250.00

17. Costs for Treatment(based on UZIS Numbers from 2002) No. of opiate addicts (F11.2) in prisons - 440 estimated costs per year: app. Euro 3,070,000

18. Costs for Treatment(based on UZIS Numbers from 2002) No. of opiate addicts (F11.2) in health sector - 843 estimated costs per year in drug-free in-patient th.: app. Euro 2,386,000 estimated costs per year in MMT: app. Euro 774,000 estimated costs per year in buprenorphine ST 8 mg: app. Euro: 1,900,000

19. Costs for Treatment(based on NIDA Numbers from USA) • 1 full year on methadone maintenance th.: app. USD 4,700 • 1 full year in the prison: app. USD 18,400

20. Costs for Treatmentif all were one year in .... • prison :Euro 8,900,000 • drug-free th.: Euro 3,600,000 • on buprenorphine:Euro 2,900,000 • on methadone: Euro 1,200,000

21. Costs for Treatment