Healthcare Provider Perspective-Driven Cost Analysis of Managing Treatment Delivery Using Time-Driven Activity-Based Costing Methodologies: An Interactive Costing Tool for Injectable Opioid Agonist Treatment
Author(s)
Hubert Michalus, BSc1, Liam Quinn, BHSc, BA1, Bethany Presley, MA1, Scott MacDonald, MD2, Craig Mitton, PhD1, Eugenia Oviedo-Joekes, PhD1;
1University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada, 2Providence Health Care, Providence Crosstown Clinic, Vancouver, BC, Canada
1University of British Columbia, School of Population and Public Health, Vancouver, BC, Canada, 2Providence Health Care, Providence Crosstown Clinic, Vancouver, BC, Canada
Presentation Documents
OBJECTIVES: Injectable opioid agonist treatment (iOAT) with diacetylmorphine and hydromorphone is a safe, effective, and cost-effective option for individuals with opioid use disorder who have not found other treatments suitable. Despite its successful integration in healthcare systems like Switzerland’s, the absence of recent data on the cost structure and care processes for iOAT may limit its broader adoption in British Columbia. This research aims to improve technical and allocative efficiency by developing an interactive costing tool for iOAT delivery.
METHODS: This study uses time-driven activity-based costing (TDABC), an innovative accounting methodology in healthcare research, to conduct a cost analysis. Data will be collected through direct observation at iOAT clinics in Vancouver to develop a process map of treatment activities and determine the time and resources needed for each step. Surveys with key stakeholders (N = 15), including physicians, nurses, and clinic managers, will gather insights into administrative processes and cost optimization strategies. Time-related data will undergo probabilistic sensitivity analysis to enhance the tool’s reliability across contexts.
RESULTS: Preliminary findings indicate that the process map will provide a comprehensive overview of the activities involved in delivering iOAT, capturing key steps in the care pathway. Cost data for medication, labour, and overheads will be matched with time units of capacity to estimate service costs. The interactive tool, developed using the latest TDABC guidelines, will feature customizable sensitivity analysis and support budget impact assessments and program planning. The full findings, including detailed cost estimates and tool outputs, will be presented at the conference.
CONCLUSIONS: This research represents the first standalone microcosting exercise for iOAT. By incorporating provider insights and a robust cost analysis, it offers a practical tool to inform resource allocation, improve service efficiency, and support iOAT program delivery. This novel approach demonstrates the potential for TDABC to enhance costing methodologies in addiction care globally.
METHODS: This study uses time-driven activity-based costing (TDABC), an innovative accounting methodology in healthcare research, to conduct a cost analysis. Data will be collected through direct observation at iOAT clinics in Vancouver to develop a process map of treatment activities and determine the time and resources needed for each step. Surveys with key stakeholders (N = 15), including physicians, nurses, and clinic managers, will gather insights into administrative processes and cost optimization strategies. Time-related data will undergo probabilistic sensitivity analysis to enhance the tool’s reliability across contexts.
RESULTS: Preliminary findings indicate that the process map will provide a comprehensive overview of the activities involved in delivering iOAT, capturing key steps in the care pathway. Cost data for medication, labour, and overheads will be matched with time units of capacity to estimate service costs. The interactive tool, developed using the latest TDABC guidelines, will feature customizable sensitivity analysis and support budget impact assessments and program planning. The full findings, including detailed cost estimates and tool outputs, will be presented at the conference.
CONCLUSIONS: This research represents the first standalone microcosting exercise for iOAT. By incorporating provider insights and a robust cost analysis, it offers a practical tool to inform resource allocation, improve service efficiency, and support iOAT program delivery. This novel approach demonstrates the potential for TDABC to enhance costing methodologies in addiction care globally.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE145
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Mental Health (including addition)