A Cost Analysis of Overdose Management at a Supervised Consumption Site in Calgary, Canada

Background and Aims: We report on a cost study, using population level data to determine the impact of emergency overdose management at supervised consumption services (SCS) versus conventional services. Design: We completed a cost analysis from a payer’s perspective. In this setting, there is a single-payer model of service delivery. Setting: In Calgary, ‘Safeworks Harm Reduction Program,’ was established in late 2017 and offers 24/7 access to SCS. The facility is a nurse-led service, available for client drop-in. We conducted a cost analysis for the entire duration of the program. This covers two years and three months. Measurements: We assessed costs using the following factors, using government health databases: monthly operational costs of providing services for drug consumption, cost of providing EMS for clients with overdoses who could not be revived at the facility, and benefit of EMS costs averted from overdoses that were successfully managed at the SCS. Findings: The proportion of clients who have overdosed at the SCS has decreased steadily for the duration of the program. The number of overdoses that can be managed on site at the SCS has trended upward, currently 98%. Each overdose that is managed at the SCS produces approximately $1,600 CAD in cost savings, with a savings of over $2.3 million for the lifetime of the program. Conclusions: Overdose management at an SCS creates cost savings by offsetting costs required for managing overdoses using emergency services.