{"edition":"usa","organization":"Shatterproof","organizationId":"ein:45-4619712","boundaryVersion":"USA-50-states-DC-v1","updated":"2026-09-14","model":{"version":"usa-shatterproof-alpha-1","costScope":"Full annual recipient resources, all programs and support; recognized in-kind and gross direct event costs included. Separate cash-like sensitivity. Clinical provider and wider social costs excluded.","geographicAttribution":"Domestic treatment-navigation health; g=.99 subjective resident share. No overseas or territorial benefits counted. State footprint is not multiplied by national population.","formula":"PY=U*f*o*e*t; Q_all=b*(PY*(d*q+w)-h); Q_USA=g*Q_all; price=10*C/Q_USA for positive Q. One annual activity cohort, short treatment exposure, discounted remaining-life QALYs in q. No repeated lifetime cohort credit.","counterfactual":"e is additional treatment net of alternative directories, clinicians, existing care and unavailable slots; b separately adjusts the effect of incremental support on recipient activity. Zero conversion or no funding additionality gives zero health absent other effects.","attribution":"Atlas receives only the net change in effective treatment, not all health among visitors. National transport of Florida engagement ratio and treatment conversion are explicit subjective judgments. Other provider/payer inputs are necessary complements, not free social resources.","uncertainty":"Weak-confidence judgment model, not a measured causal return or probability interval. Scenarios span strong conversion, negligible yield, zero and negative health. No source identifies the marginal conversion parameter; root should treat price as provisional.","nativeOutcomes":"Users, sessions, profile views, additional treatment starts and retained treatment-years. Health counted only after the explicit treatment conversion and clinical bridge.","inputs":[{"name":"C","value":52809073,"unit":"USD annual full recipient resource cost","basis":"observed","rationale":"Audited gross 2024 expense, restoring direct donor benefits; includes recognized donated media and services. The 2024 costs and 2025 reach are paired as a stationary-scale approximation, not a same-year measured unit cost.","sourceIds":["shat-audit24"]},{"name":"U","value":1200000,"unit":"annual Atlas users","basis":"observed","rationale":"2025 report says more than 1.2 million people; use rounded floor, not unique patients or starts.","sourceIds":["shat-impact25"]},{"name":"f","value":0.06622091648937967,"unit":"profile engagements per user","basis":"judgment","rationale":"Florida quarter 1,961 profile views / 29,613 users = .06622. Transport to national annual population is subjective; repeat views and national mix could differ.","sourceIds":["shat-florida"]},{"name":"o","value":0.2,"unit":"OUD-relevant fraction of profile engagements","basis":"judgment","rationale":"20% reserves most engagements for alcohol/other disorders, caregivers or irrelevant contacts; not measured Atlas case mix.","sourceIds":[]},{"name":"e","value":0.03,"unit":"net additional effective treatment starts per OUD engagement","basis":"judgment","rationale":"3% after non-enrollment, inappropriate capacity, alternative locators and treatment that would happen anyway. A weak prior, not a measured Atlas effect; test zero.","sourceIds":["shat-florida","shat-resources"]},{"name":"t","value":0.25,"unit":"additional retained treatment years per start","basis":"judgment","rationale":"Quarter-year retained treatment exposure conditional on an additional start already adjusted for alternative care in e; no second subtraction of the same otherwise-received start and no lifelong adherence assumed.","sourceIds":["shat-moud"]},{"name":"b","value":0.5,"unit":"marginal funding additionality","basis":"judgment","rationale":"50% allows replacement of other donations, reserves and public contracts. This is separate from patients finding care anyway in e.","sourceIds":["shat-audit24"]},{"name":"d","value":0.01,"unit":"net deaths prevented per additional treatment-year","basis":"judgment","rationale":"1% between historical buprenorphine and methadone cohort rate gaps; discounts confounding and modern transport, includes induction/discontinuation risks rather than using peak untreated risk.","sourceIds":["shat-moud"]},{"name":"q","value":15,"unit":"discounted QALYs per premature death prevented","basis":"judgment","rationale":"15, broadly about 30 remaining years at .77 utility and 3% discount; not patient-level survival evidence. Test 10–20.","sourceIds":[]},{"name":"w","value":0.05,"unit":"nonfatal QALYs per additional treatment-year","basis":"judgment","rationale":"Small .05 utility improvement while retained, separately from mortality. Could be zero/negative; no long-term recovery dividend.","sourceIds":[]},{"name":"g","value":0.99,"unit":"50-state/DC resident share of modeled health","basis":"judgment","rationale":"99% for domestic navigation, allowing nonresident use. Not inferred from headquarters or a claim all online users are residents.","sourceIds":[]},{"name":"h","value":0,"unit":"other net health harm per annual activity cohort before funding additionality","basis":"judgment","rationale":"Net zero centrally for unpriced prevention, stigma, policy and adverse effects; not established zero or a proven lower bound.","sourceIds":[]}],"scenarios":[{"id":"central","label":"Weak-confidence best estimate","costUSD":52809073,"allPopulationQalys":11.91976496808834,"editionQalys":11.800567318407458,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0.03,\"t\":0.25,\"b\":0.5,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=119.1976496808834."},{"id":"favorable","label":"Much stronger treatment conversion and retention","costUSD":52809073,"allPopulationQalys":2880,"editionQalys":2851.2,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.15,\"o\":0.4,\"e\":0.1,\"t\":1,\"b\":0.8,\"d\":0.02,\"q\":20,\"w\":0.1,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=7200."},{"id":"poor","label":"Almost no additional effective treatment","costUSD":52809073,"allPopulationQalys":0.00108,"editionQalys":0.0010692,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.03,\"o\":0.1,\"e\":0.001,\"t\":0.1,\"b\":0.1,\"d\":0.002,\"q\":10,\"w\":0.01,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=0.36000000000000004."},{"id":"cash-like","label":"Excludes recognized donated resources from numerator","costUSD":21522901,"allPopulationQalys":11.91976496808834,"editionQalys":11.800567318407458,"assumptions":"{\"C\":21522901,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0.03,\"t\":0.25,\"b\":0.5,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=119.1976496808834."},{"id":"no-conversion","label":"No net treatment change","costUSD":52809073,"allPopulationQalys":0,"editionQalys":0,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0,\"t\":0.25,\"b\":0.5,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=0."},{"id":"adverse","label":"No treatment benefit plus 10 QALYs other harm","costUSD":52809073,"allPopulationQalys":-5,"editionQalys":-4.95,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0,\"t\":0.25,\"b\":0.5,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":10}; additional treatment-years before funding additionality=0."},{"id":"other-harm","label":"25 QALYs other net harm","costUSD":52809073,"allPopulationQalys":-0.5802350319116591,"editionQalys":-0.5744326815925426,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0.03,\"t\":0.25,\"b\":0.5,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":25}; additional treatment-years before funding additionality=119.1976496808834."},{"id":"low-funding-additionality","label":"Only 10% additional capacity","costUSD":52809073,"allPopulationQalys":2.3839529936176684,"editionQalys":2.3601134636814916,"assumptions":"{\"C\":52809073,\"U\":1200000,\"f\":0.06622091648937967,\"o\":0.2,\"e\":0.03,\"t\":0.25,\"b\":0.1,\"d\":0.01,\"q\":15,\"w\":0.05,\"g\":0.99,\"h\":0}; additional treatment-years before funding additionality=119.1976496808834."}],"sensitivity":["Central effective treatment yield before funding substitution is about 0.0000993 treatment-years per user. This is a judgment, not an observed conversion rate.","At other central inputs, e must be 1.3425 to beat $1 million per 10 USA QALYs, or 13.4254 to beat $100,000: impossible as a probability without stronger case mix, retention or other beneficial pathways.","At full resource costs, thresholds are about 2,667 / 26,671 additional treatment-years after funding substitution for $1 million / $100,000 per 10 QALYs, using .2 QALY per year and g=.99.","Net other harm above 23.84 QALYs before funding additionality erases the central benefit; harm is not multiplied by the treatment-conversion probability.","The cash-like denominator lowers price by 59.2%, but donated advertising fair value is not necessarily its opportunity cost. A social model must add care costs and account for media displacement.","If geographic share is .95 rather than .99, price rises 4.2%; treatment conversion and funding additionality dominate."],"missingInputs":["National linked enrollment, medication mix, retained treatment duration and comparator outcomes, with repeat users/caregivers separated.","Current activity-to-budget relationship and specific unfunded expansion; marginal public/private substitution and state contract restrictions.","Causal treatment/health effects of provider education, stigma campaigns and policy branches, including substitution and potential harms.","Current patient-level survival and quality-of-life inputs, clinical payer costs, media opportunity costs and resident attribution."]},"sources":[{"id":"shat-audit24","title":"2024 audited financial statements, pp. 4–5 and notes 2, 7","publisher":"Shatterproof / CliftonLarsonAllen","url":"https://www.shatterproof.org/sites/default/files/2025-10/2024%20Shatterproof%20Financial%20Audit_0.pdf","published":"2025-09-12","retrieved":"2026-09-14"},{"id":"shat-audit23","title":"2023 audited financial statements with 2022 comparative information","publisher":"Shatterproof / independent auditor","url":"https://www.shatterproof.org/sites/default/files/2024-12/FINAL%202023%20Shatterproof%20Financial%20Statements.pdf","published":"2024-09-27","retrieved":"2026-09-14"},{"id":"shat-impact25","title":"2025 Impact Report","publisher":"Shatterproof","url":"https://www.shatterproof.org/sites/default/files/2026-05/Impact_report_25_05_16_26.pdf","published":null,"retrieved":"2026-09-14"},{"id":"shat-financials","title":"Current financial reports index","publisher":"Shatterproof","url":"https://shatterproof.org/about-us/media-room/financials","published":null,"retrieved":"2026-09-14"},{"id":"shat-florida","title":"Atlas quarterly monitoring, October–December 2025","publisher":"Florida Department of Children and Families / Shatterproof","url":"https://development.myflfamilies.com/external/documents/66691.pdf","published":"2026-01-27","retrieved":"2026-09-14"},{"id":"shat-moud","title":"Mortality risk during and after opioid substitution treatment: cohort meta-analysis","publisher":"Sordo and colleagues / BMJ","url":"https://www.bmj.com/content/357/bmj.j1550","published":"2017-04-26","retrieved":"2026-09-14"},{"id":"shat-resources","title":"Treatment Atlas provider resources and quality improvement","publisher":"Shatterproof","url":"https://treatmentatlas.org/resources-providers","published":null,"retrieved":"2026-09-14"}]}