Costs of syringe vending machines in Tbilisi, Georgia.


Journal

Harm reduction journal
ISSN: 1477-7517
Titre abrégé: Harm Reduct J
Pays: England
ID NLM: 101153624

Informations de publication

Date de publication:
02 08 2023
Historique:
received: 25 04 2023
accepted: 16 07 2023
medline: 4 8 2023
pubmed: 3 8 2023
entrez: 2 8 2023
Statut: epublish

Résumé

Syringe vending machines (SVM) can improve access to sterile injecting equipment, but they have not been widely implemented or evaluated. We evaluate the cost of SVM installed between July 2019-December 2020 in Tbilisi, Georgia. The SVM were stocked with several kit types, including injecting equipment for opioid or stimulant users, naloxone, male and female condoms, and pregnancy tests. We gathered financial data from the project to estimate fixed (staff time, start-up costs, equipment, running costs, and consumables) and variable (harm reduction kits) costs. We calculated the full cost of the SVM intervention, cost per user, cost per additional syringe accessed by SVM users, and cost per kit distributed (2020 Euros). SVM access cards were issued to 1132 users, and 29,238 kits were distributed through SVM, total cost €204,358. Staff costs were 51% of total, consumable costs 28%, equipment 10%, and start up, recurrent costs, and overheads 5% or less each. Opioid and stimulant kits were most accessed (35% and 32% of total). Cost per user was €66/year, and cost per transaction €7, of which €5 fixed costs and €2 variable. If monthly transactions increased from the average of 1622/month to highest monthly usage (4714), fixed costs per transaction would decrease to < €1. It cost €0.55 per additional syringe accessed/user/month. This study provides evidence for governments about the cost of SVM, a novel harm reduction intervention. This is particularly relevant where Global Fund is withdrawing and harm reduction services need to be incorporated into national budgets.

Sections du résumé

BACKGROUND
Syringe vending machines (SVM) can improve access to sterile injecting equipment, but they have not been widely implemented or evaluated. We evaluate the cost of SVM installed between July 2019-December 2020 in Tbilisi, Georgia.
METHODS
The SVM were stocked with several kit types, including injecting equipment for opioid or stimulant users, naloxone, male and female condoms, and pregnancy tests. We gathered financial data from the project to estimate fixed (staff time, start-up costs, equipment, running costs, and consumables) and variable (harm reduction kits) costs. We calculated the full cost of the SVM intervention, cost per user, cost per additional syringe accessed by SVM users, and cost per kit distributed (2020 Euros).
RESULTS
SVM access cards were issued to 1132 users, and 29,238 kits were distributed through SVM, total cost €204,358. Staff costs were 51% of total, consumable costs 28%, equipment 10%, and start up, recurrent costs, and overheads 5% or less each. Opioid and stimulant kits were most accessed (35% and 32% of total). Cost per user was €66/year, and cost per transaction €7, of which €5 fixed costs and €2 variable. If monthly transactions increased from the average of 1622/month to highest monthly usage (4714), fixed costs per transaction would decrease to < €1. It cost €0.55 per additional syringe accessed/user/month.
CONCLUSIONS
This study provides evidence for governments about the cost of SVM, a novel harm reduction intervention. This is particularly relevant where Global Fund is withdrawing and harm reduction services need to be incorporated into national budgets.

Identifiants

pubmed: 37533020
doi: 10.1186/s12954-023-00829-3
pii: 10.1186/s12954-023-00829-3
pmc: PMC10394772
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

103

Subventions

Organisme : Department of Health
Pays : United Kingdom

Informations de copyright

© 2023. The Author(s).

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Auteurs

Josephine G Walker (JG)

Population Health Sciences, University of Bristol, Bristol, UK. josephine.walker@bristol.ac.uk.

Irma Kirtadze (I)

Alternative Georgia, Tbilisi, Georgia.
Ilia State University, Tbilisi, Georgia.

Mzia Tabatadze (M)

Alternative Georgia, Tbilisi, Georgia.

Peter Vickerman (P)

Population Health Sciences, University of Bristol, Bristol, UK.

David Otiashvili (D)

Alternative Georgia, Tbilisi, Georgia.
Ilia State University, Tbilisi, Georgia.

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