NICE’s needle and syringe programmes economic evidence: a summary
The National Institute for Health and Care Excellence (NICE) has published two public health guidance documents on NSPs: PH18 (2009)1 and PH52 (2014). 2 The economic arguments for NSP investment come from the economic modelling report accompanying PH18. Modellers explored the level of syringe coverage, opiate substitution therapy (OST) participation, and hepatitis C treatment required to reduce HIV and hepatitis C prevalence among people who inject drugs.
The results suggested that:
- NSP-related interventions that increase the number of people receiving drug/ hepatitis C treatment or using clean injecting equipment are likely to be cost- effective
- Handing out more syringes or increasing the number of people in OST is sufficient for controlling HIV. However, it is not enough to reduce hepatitis C infections; substantial decreases are likely to occur from a mix of services, such as pharmacies, NSPs and specialist drug and hepatitis C treatment
- Although not explicitly modelled, possible strategies that could increase syringe coverage include opening NSPs for longer hours or using mobile vans or vending machines to widen access