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greatest percentage of the respective sums has in turn been provided by the provinces(ÖBIG 2002). More recent figures on provincial expenditure in this specific field are notavailable. In addition, treatment centres announced in the Federal Collection ofStatutes according to Section 15 of the SMG may receive funding from the FederalMinistry of Health. In 2009 this amounted to a total of EUR 2 051 868 (communicationby the Federal Ministry of Health). Part of this sum is also spent for inpatient drugtreatment.Table 12.2Outpatients, estimated number of days of service delivery and funding sources, intreatment centres covered by DOKLI, in 2009CoveragePeopletreated 1Health insurancefundSource of funding (percentages) 2ProvincesCourtauthoritiesNo per-casefundingAustria, nationwide 9 759 - - - -Austria excl. Vienna 6 556 10% 26% 3% 63%Note 1: All people treated in 2009.Note 2: Percentage of actual funding source, investigated at the end of treatment, relating to those patientswhose outpatient treatment ended in 2009, not including Vienna (multiple answers were permitted). The figuresrelating to funding source do not include Vienna because data on funding sources are not transferred fromVienna's BADO documentation system to the nationwide DOKLI system (see GÖG/ÖBIG 2010a).Source: GÖG/ÖBIG, DOKLI analysis of client year 2009; representation by GÖG/ÖBIGNo data on costs per day of outpatient treatment are available.12.4 Cost of substitution treatmentAlthough there are problems regarding the data quality of the substitution registry(e.g., ghost cases; see Chapters 4.1 and 5.4 as well as GÖG/ÖBIG 2010b), it is stillobvious that the number of people undergoing opioid substitution treatment hasstrongly risen over the years (see Chapter 5.4). For 2009, the number of 'OST-days' 50is estimated to be between 2.4 and 4 million.50The total of 10 837 people in substitution treatment on 30 June 2009 multiplied by 365. In order to take intoaccount ghost cases, the lower limit of 60% of the number derived has been given (see GÖG/ÖBIG 2010b).112 © GÖG/ÖBIG, <strong>Report</strong> on the Drug Situation 2010
According to the Main Association of Austrian Social Security Institutions, the cost ofsubstitution medicines taken over by the social security institutions was EUR 25 millionin 2009. Only substances that are exclusively prescribed for substitution treatmenthave been considered here (Näglein, personal communication).Because in most provinces OST is primarily provided by established doctors, visits tothese physicians are relevant for costs. Only Vienna, Upper Austria and the Tyrol granta separate OST remuneration in addition to the standard fees for consultations withdoctors: in Vienna, EUR 26 per patient may be charged ten times a quarter at the most;in Upper Austria, it is EUR 65 for first-time and renewed stabilisation and EUR 20 fivetimes a quarter for subsequent treatment; and doctors in the Tyrol may charge EUR 25three times a quarter (Schwarzenbrunner, personal communication). In Salzburg, where90% of substitution treatments are delivered by the SUST Substitution Centre for OpiateAddicts and the Drug Outpatient Department of Christian Doppler Hospital, the healthinsurance funds grant a lump sum of EUR 202 per quarter plus reimbursement ofexpenses of EUR 74 for substitution substances per patient and month, in the case ofpatients who have health insurance. If patients do not carry insurance, the correspondingcosts are taken over by the Province (Schabus-Eder, personal communication).In Carinthia the social insurance institutions pay EUR 62 a year for diagnosing, firsttreatment and renewed stabilisation, plus EUR 19 five times a quarter at the most.Here, almost all substitution treatments are carried out by two established outpatientclinics not affiliated to hospitals. In Vorarlberg, established doctors who haveadditional consulting hours in drug treatment centres may obtain EUR 74 per quarterand patient (Schwarzenbrunner, personal communication; see also Chapter 5.1).Regarding cost of substitution medicines for prisoners, figures for 2009 are available:approximately EUR 1.4 million was spent for substitution substances. The average costper patient amounted to EUR 1 470 (Parliament enquiry No. 4288/J-NR/2010).12.5 ConclusionsBecause of the complex financing structure and budgets which are not broken down bydrug-related spending in most cases, expenditure for drug-related treatment can onlybe given as a rough estimate. A detailed analysis of the corresponding cost wouldrequire much time and involve considerable cost, and no studies on this subject areavailable. The selected issues chapter of our 2002 <strong>Report</strong> to the EMCDDA (ÖBIG 2002)provides some information in this field: the overall cost of drug-related treatment wasestimated to amount to EUR 40 770 400 in 1999 and EUR 50 736 800 in 2001. Thesefigures include expenditure for inpatient and outpatient treatment centres, opioidsubstitution treatment, interventions according to the principle of therapy instead ofpunishment, treatment in prison, inpatient treatment in hospital as well as summarisedother expenses by health insurance funds. As some of the available data indicate aconsiderable rise in treatment cost compared to the years studied for the 2002 reportChapter 12 / Cost of Drug-related Treatment 113
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Report on the Drug
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ISBN-13 978-3-85159-153-8Owner, edi
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PreventionThe trend towards drawing
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hardly known. This makes it impossi
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6 Health Correlates and Consequence
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Tables and FiguresTablesTable 6.1Ta
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Table A22Table A23Table A24Table A2
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Figure 9.1Figure 9.2Figure 9.3Figur
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Part ANew Developmentsand Trends
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The amendment to the Narcotic Drugs
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deaths (see GÖG/ÖBIG 2009b) conti
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In the reporting period, no new dev
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2.1 Drug use in the general populat
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The quitting rate 3 is considerably
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Figure 2.2Experience of cannabis us
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described on the individual website
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ehaviour is elevated for children i
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theme of the Gesunde Gemeinden (hea
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party scenes are relevant settings.
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support if needed. The project is i
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approximations and have to be inter
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Figure 4.22-sample CRC estimates wi
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5 Drug-related Treatment: Treatment
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2010, now 50 doctors are entitled t
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patients for inpatient treatment al
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Map 5.2Specialised providers of out
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cooperation structures linking the
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events are organised, and on the ot
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5.3 Characteristics of treated clie
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play the most important role in the
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existing treatment system who do no
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5.4 Trends of clients in treatmentA
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Figure 5.7First substitution treatm
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6 Health Correlates and Consequence
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Table 6.1Data on hepatitis B, hepat
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ange from affective disorders (e.g.
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Figure 6.1Share of directly drug-re
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Page 84 and 85: distribution of condoms) is provide
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Page 90 and 91: Map 8.1Specialised providers of inp
Page 92 and 93: The Lighthouse housing project of M
Page 94 and 95: empowerment that had been aimed at,
Page 96 and 97: handling of drugs: Section 27 of th
Page 98 and 99: also shows regarding prison sentenc
Page 100 and 101: Stadtpark, and Westbahnhof station.
Page 102 and 103: mation on final convictions because
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Page 106 and 107: 10 Drug MarketsThe substance most f
Page 108 and 109: head shop in Graz (Styria) in Augus
Page 110 and 111: (from 2005 to 2008, the correspondi
Page 113: Part BSelected Issues
Page 116 and 117: national quality standards for medi
Page 118 and 119: Also, both at federal and provincia
Page 120 and 121: Table 11.1, continuedTitle and year
Page 122 and 123: Plans for new guidelines and standa
Page 124 and 125: 12 Cost of Drug-related TreatmentTh
Page 126 and 127: centres so far (Schweizer Haus Hade
Page 130 and 131: (e.g., days of hospital stay becaus
Page 133 and 134: BibliographyAPA 2010. AIDS 2010. Wi
Page 135 and 136: EMCDDA 2000. Treatment demand indic
Page 137 and 138: Haas, S. (2005). Problembewusste Fr
Page 139 and 140: Pont, J.; Wool, R. (2006). Ein Leit
Page 141 and 142: VIVID 2010. Jahresbericht 2009. VIV
Page 143 and 144: Personal Communications(alphabetica
Page 145 and 146: Caritas Marienambulanz. Drug relate
Page 147 and 148: Low threshold service Ganslwirt(Ver
Page 149 and 150: Viennese pilot project “Pregnancy
Page 151 and 152: Lower Austria: Fachstelle für Such
Page 153 and 154: Caritas Innsbruckhttp://www.caritas
Page 155 and 156: Otto-Wagner-Spital — Drogeninstit
Page 157: AnnexA. Tables, MapB. List of Abbre
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Page 163 and 164: Table A2, continuedStudy(author(s),
Page 165 and 166: Table A5Number of directly drug-rel
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Page 169 and 170: Table A11Distribution of reports of
Page 171 and 172: Table A15Final convictions under th
Page 173 and 174: Table A18Seizures of narcotic drugs
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Table A26Persons starting drug trea
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Table A29Current health problems of
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The programme plus is implemented i
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Proven regional interventions run f
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Table A34Austrian population statis
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Annex BList of Abbreviations
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HCVHCV-AbHCV-RNAHIVICD-10IFESISDISP
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List of Standard Tables of 2010 and
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