• Kun-Chia Chang, Kuan-Ying Lee, Tsung-Hsueh Lu, Jing-Shiang Hwang, Chia-Ni Lin, Shuo-Yen Ting, Chih-Cheng Chang, and Jung-Der Wang.
• Jianan Psychiatric Center, Ministry of Health and Welfare, 539 Yuzhong Rd., Rende Dist., Tainan 71742, Taiwan; Department of Public Health College of Medicine, National Cheng Kung University, 1 University Rd., East Dist., Tainan 701, Taiwan. Electronic address: kunchiachang0517@gmail.com.
• Drug Alcohol Depend. 2019 Aug 1; 201: 197-204.

BackgroundThis study estimated the long-term changes of opioid agonist treatment (OAT) in quality of life (QOL) and quantified the quality-adjusted life years (QALY) from the loss of quality-adjusted life expectancy (QALE) in heroin users.MethodsA total of 1283 heroin users stratified by OAT were linked to the National Mortality Registry for 8 years (2006-2014) to obtain survival functions, which were extrapolated to lifetime by applying a rolling extrapolation algorithm to survival ratio between the sub-cohorts and age- and sex-matched referents simulated from vital statistics of Taiwan. We performed cross-sectional measurement of EQ-5D on 349 participants, including those with a valid state of OAT or non-OAT plus newly recruited consecutive patients, during 2015-2017 for utility values, while the QOL of referents were abstracted from the 2009 National Health Interview Survey. The QALE was calculated by summing the products of the mean QOL and survival rate throughout life. The QALE difference between the cohort and corresponding referents was the loss-of-QALE.ResultsQOL of the OAT group was significantly better than that of the non-OAT group in every domain of the EQ-5D, which was quantified to be 0.23 for utility after controlling for other variables. After extrapolation to 70 years, the estimated QALE and loss-of-QALE were 17.8 and 18.2 QALY for OAT subjects, respectively, while those of the non-OAT group were 9.2 and 27.9 QALY.ConclusionsReceiving OAT could reduce QALE lost by 9.7 QALYs compared with non-OAT after accounting for QOL differences along time and different age and sex distributions.Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

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