Open AccessEstimated cost of comprehensive syringe service program in the United States
Author(s) -
Eyasu H. Teshale,
Alice Asher,
Maria Aslam,
Ryan Augustine,
Eliana Duncan,
Alyson Rose-Wood,
John W. Ward,
Jonathan Mermin,
Kwame Owusu-Edusei,
Patricia M. Dietz
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0216205
Subject(s) - activity based costing , business , service (business) , syringe , total cost , rural area , location , average cost , cost estimate , operations management , geography , medicine , marketing , economics , neoclassical economics , accounting , geodesy , management , pathology , psychiatry
Objective To estimate the cost of establishing and operating a comprehensive syringe service program (SSP) free to clients in the United States. Methods We identified the major cost components of a comprehensive SSP: (one-time start-up cost, and annual costs associated with personnel, operations, and prevention/medical services) and estimated the anticipated total costs (2016 US dollars) based on program size (number of clients served each year) and geographic location of the service (rural, suburban, and urban). Results The estimated costs ranged from $0.4 million for a small rural SSP (serving 250 clients) to $1.9 million for a large urban SSP (serving 2,500 clients), of which 1.6% and 0.8% is the start-up cost of a small rural and large urban SSP, respectively. Cost per syringe distributed varied from $3 (small urban SSP) to $1 (large rural SSP), and cost per client per year varied from $2000 (small urban SSP) to $700 (large rural SSP). Conclusions Estimates of the cost of SSPs in the United States vary by number of clients served and geographic location of service. Accurate costing can be useful for planning programs, developing policy, allocating funds for establishing and supporting SSPs, and providing data for economic evaluation of SSPs.