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9 Frameworks to Guide the Assessment of Legal and Regulatory Challenges
Pages 97-104

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From page 97...
... . • A policy analysis framework requires making value judgments and weighting outcomes, projecting policy impacts of different alternatives, and considering feasibility and the likely chal lenges to implementation such as political and community support (R.
From page 98...
... A POLICY ANALYSIS FRAMEWORK TO SUPPORT HEALTH POLICY DECISIONS To facilitate workshop discussions on how best to identify policy measures that would most effectively expand the use of methadone, Frank proposed a seven-step policy analysis framework, focusing this framework on regulations that affect the supply of methadone and accompanying policies that might be changed to improve health and well-being by reducing harms associated with opioid use disorder (OUD)
From page 99...
... For example, the interaction of Medicaid and prison policy is a classic case of how a large national payment policy structure interacts with a particular context and specific setting, he said. Frank suggested that the policy alternatives most likely to succeed are bundles of complementary policies designed specifically to address desired outcomes, but with appropriate attention to potential unintended consequences, implementation uncertainty, and potential community resistance.
From page 100...
... For example, evidence now exists regarding the consequences of expanding Medicaid generally and specifically for addiction treatment, yet there is far less data concerning other regulatory provisions, such as changing Medicaid rules for incarcerated populations, he said. Creating policies that make meaningful change in the capacity to address medications for OUD requires policy makers to understand all the different levers that need to be pulled rather than looking at each policy in isolation, said Frank.
From page 101...
... To aid in the collection of information on resources used in delivery of treatment for substance use disorder, French and colleagues developed an instrument called DATCAP -- the Drug Abuse Treatment Cost Analysis Program.1 Another type of evaluation that helps determine if investing in a certain resource or treatment will lead to cost savings down the road is called cost-offset analysis, said French. This type of analysis is particularly useful for harm reduction programs, he said.
From page 102...
... French said the most common economic analysis approach used in the medical literature is cost-utility analysis, which is an extension of-cost effectiveness analysis, but with an outcome that takes into account improvements in both the quality and duration of life, such as quality-adjusted life years. Like cost-effectiveness analysis, cost-utility analysis does not adequately capture the benefits of addiction treatment beyond patient wellbeing and duration of life.
From page 103...
... . • Include all externalities, pain and suffering, shared resources, and hidden costs.


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