Drug Program for Pregnant Women Could Save Billions

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The Early Start program has been offered at Keiser Permanente hospitals in California for many years. The program (outlined here) starts with the idea that substance abuse is a treatable condition and focuses on women who have recently become pregnant.

Now, using data gathered over five years across a very large patient base (more than 39,000 pregnancies a year receive prenatal care in Kaiser Permanente facilities), a cost analysis has been published. As reported by Medical News Today, if the program were put in place nationwide, overall healthcare savings would amount to almost two billion dollars annually. That’s an impressive number.

The importance of this analysis goes beyond better healthcare for pregnant women and their unborn children. The real heft comes because a strong policy motivator is reducing healthcare costs. Decisions about particular treatments are between a doctor and a patient – this relationship is hard to reach. However, setting national policies based on dollar savings is something that has a much broader reach. And in this case, it is unlikely that insurance companies and the government will be at odds. After all, both parties are looking for just this type of cost saving measure.

Perhaps the most impressive part of the study was how well counseling works. Women with known substance abuse problems – alcohol, cigarettes and even illegal drugs – could have nearly the same outcomes as those who do not use at all. Since even a small lowering of postpartum problems is significant, the fact that substance abusers can move into the “normal pregnancy” column is remarkable.

In a society where substance abuse that harms a fetus can be, and has been, prosecuted as a crime, this information should have an impact. The rational path seems to be to adopt some form of the Early Start Program nationwide. The essential ingredients are urine drug testing early on and having an addiction counselor on staff. These are not huge addition costs – especially when the savings, both money and in human tragedy, are so obvious.

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