{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:49:59Z","timestamp":1790369399224,"version":"4.1.0"},"reference-count":92,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R37\u2010DA15612"],"award-info":[{"award-number":["R37\u2010DA15612"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>The United States (US) is experiencing a surge in methamphetamine use. Treatment options for methamphetamine use disorder (MethUD) focus on behavior change, particularly via contingency management (CM), where individuals receive rewards for submitting drug\u2010free urine samples or for other positive behaviors such as attending treatment sessions. Little is known about the cost\u2010effectiveness of CM for treating MethUD, including the January 2025 decision by the US federal government to increase the maximum annual CM incentive ten\u2010fold to $750 per patient. This study aimed to assess the cost\u2010effectiveness of CM for individuals with MethUD in the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>We developed a microsimulation model of methamphetamine use behavior among individuals with MethUD to assess the effectiveness and cost\u2010effectiveness of CM for treating MethUD. We modeled methamphetamine use states and psychiatric and cardiovascular comorbidities. We considered a 12\u2010week and 24\u2010week CM program, with a maximum $750 incentive. We simulated the model in weekly time steps over the lifetime of a cohort of 10\u2009000 individuals with MethUD, under the status quo (no treatment) and with the CM program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Number of deaths over one year and lifetime per person healthcare costs (healthcare sector perspective) and quality\u2010adjusted life years (QALYs) experienced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>With no treatment, 274 overdose deaths and 305 total deaths occurred in the cohort over 1\u00a0year. Individuals experienced 11.37 lifetime QALYs and incurred $216\u2009320 in lifetime healthcare costs. With a 12\u2010week CM program, an estimated 117 deaths were prevented over 1\u00a0year, with a net gain of 0.70 lifetime QALYs per person and incremental cost of $6850 compared with no treatment, yielding an incremental cost\u2010effectiveness ratio (ICER) of $9830\/QALY gained [95% credible interval (CR) = $8100\u2013$11\u2009400]. With a 24\u2010week program, 153 deaths were prevented over 1\u00a0year, with a net gain of 0.81 lifetime QALYs per person and incremental cost of $10\u2009000, yielding an ICER of $12\u2009312\/QALY gained (95% CR = $10\u2009400\u2013$14\u2009100). Even under the pessimistic assumption of no lasting behavior change after CM program completion, the programs cost less than $130\u2009000\/QALY gained. Threshold analysis suggests that at a $50\u2009000 willingness to pay, the 24\u2010week program would be cost\u2010effective even if the maximum incentive were $2491.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modelling shows that contingency management appears to be a highly cost\u2010effective intervention for treating methamphetamine use disorder, even with conservative assumptions and a $750 incentive cap. When cost impacts in the criminal justice and child welfare systems are included, such programs are likely cost\u2010saving.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70377","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T01:04:18Z","timestamp":1773191058000},"page":"2127-2140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2010effectiveness of contingency management for methamphetamine use disorder: A model\u2010based analysis"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3044-4107","authenticated-orcid":false,"given":"Gary L.","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Management Science and Engineering Stanford University  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7564-7067","authenticated-orcid":false,"given":"Yupeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Management Science and Engineering Stanford University  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Rawson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of California at Los Angeles  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0694-5761","authenticated-orcid":false,"given":"Keith","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University  Stanford CA USA"},{"name":"Center for Innovation to Implementation, Veterans Affairs Healthcare System  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9331-8920","authenticated-orcid":false,"given":"Margaret L.","family":"Brandeau","sequence":"additional","affiliation":[{"name":"Department of Management Science and Engineering Stanford University  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMSHA).Using SAMSHA funds to implement evidence\u2010based contingency management services. 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