Effects of personal costs of methadone maintenance, especially time price, on treatment attendance.

摘要

The study provides conclusive evidence on existence of economic barriers, namely money price and time price, to regular treatment attendance for methadone maintenance clients. The study is designed to develop improved time price measures and investigate their effect on treatment attendance. Regular attendance is essential for methadone maintenance because, form client's perspective, it may affect treatment outcomes and, from methadone maintenance clinic's perspective, it reduces the clinics losses in terms of idle stuff time and under-utilization of equipment.;Correct estimates of time price elasticity are important because of the possibility that treatment attendance could be rationed on the basis of time price, especially in the case of free methadone maintenance provision. However, no studies have been undertaken to investigate the effect of time on treatment attendance for methadone maintenance clients.;Four hypotheses concerning treatment attendance are tested. First, increasing the full price of access to methadone maintenance will reduce treatment attendance among methadone maintenance clients. Second, the time price of methadone maintenance will have more pronounced effect on treatment attendance compare to money price in case of free methadone maintenance provision. Third, use of wage rate in determining the time price of methadone maintenance will produce biased estimates of time price elasticity. Finely, willingness to pay for a reduction in time requirements to obtain methadone maintenance will correspond more closely to the true value of time than willingness to accept a compensation to forgo the reduction.;Time price elasticity ranged from -0.004 to -0.009 using willingness to pay specification of the time price. The analysis shows that treatment attendance of clients with free methadone maintenance provision is more responsive to the changes in time price (1) than to the changes in money price, and (2) than treatment attendance of clients with non-free methadone maintenance provision. Time prices estimated with the wage rate produced biased estimates of time price elasticity. These findings suggest public policies that would reduce travel or waiting time for methadone maintenance clients. Finely, the analysis suggests that the most appropriate measure of the value of time in obtaining methadone maintenance is willingness to pay for a reduction in treatment time requirement.