Health economic design for cost, cost-effectiveness and simulation analyses in the HEALing Communities Study

Arnie P. Aldridge, Carolina Barbosa, Joshua A. Barocas, Joshua L. Bush, Jagpreet Chhatwal, Kristin J. Harlow, Ayaz Hyder, Benjamin P. Linas, Kathryn E. McCollister, Jake R. Morgan, Sean M. Murphy, Caroline Savitzky, Bruce R. Schackman, Eric E. Seiber, Laura E Starbird, Jennifer Villani, Gary A. Zarkin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The HEALing Communities Study (HCS) is designed to implement and evaluate the Communities That HEAL (CTH) intervention, a conceptually driven framework to assist communities in selecting and adopting evidence-based practices to reduce opioid overdose deaths. The goal of the HCS is to produce generalizable information for policy makers and community stakeholders seeking to implement CTH or a similar community intervention. To support this objective, one aim of the HCS is a health economics study (HES), the results of which will inform decisions around fiscal feasibility and sustainability relevant to other community settings. Methods: The HES is integrated into the HCS design: an unblinded, multisite, parallel arm, cluster randomized, wait list–controlled trial of the CTH intervention implemented in 67 communities in four U.S. states: Kentucky, Massachusetts, New York, and Ohio. The objectives of the HES are to estimate the economic costs to communities of implementing and sustaining CTH; estimate broader societal costs associated with CTH; estimate the cost-effectiveness of CTH for overdose deaths avoided; and use simulation modeling to evaluate the short- and long-term health and economic impact of CTH, including future overdose deaths avoided and quality-adjusted life years saved, and to develop a simulation policy tool for communities that seek to implement CTH or a similar community intervention. Discussion: The HCS offers an unprecedented opportunity to conduct health economics research on solutions to the opioid crisis and to increase understanding of the impact and value of complex, community-level interventions.

Original languageEnglish (US)
Article number108336
JournalDrug and Alcohol Dependence
StatePublished - Dec 1 2020


  • Cost-effectiveness
  • Economic evaluation
  • HEALing Communities Study
  • Helping to end addiction long term
  • Opioid use disorder
  • Overdose
  • Simulation

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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