{"path":"docs/open-botec/estimates/us-il-chicago/cra-naloxone.json","schemaVersion":"open-botec/0.1","id":"slug:chicago-recovery-alliance/naloxone-distribution/naloxone-distribution/us-il-chicago/2017/v1","key":{"org":{"name":"Chicago Recovery Alliance","orgId":"slug:chicago-recovery-alliance","ein":null},"program":{"slug":"naloxone-distribution","name":"Peer naloxone distribution"},"geography":{"geoId":"us-il-chicago","name":"Chicago, Illinois","beneficiaryBasis":"service-location"},"year":2017,"modelVersion":"v1","archetypeId":"naloxone-distribution"},"status":{"tier":"draft","since":"2026-10-18","confidence":"very-low"},"template":{"archetypeId":"naloxone-distribution","templateVersion":"v1","parameterSets":["parameters/us-il-chicago/naloxone-distribution.json"],"overrides":[]},"scope":{"counterfactual":"Other Chicago distributors, CDPH outreach and EMS continue.","templateFitNote":"Kit-based; 2017 data. The repo's existing CRA model (data/chicago/cra-pre-recalibration-model.json) uses a population-reach structure instead and is not comparable."},"inputs":{"utility":{"label":"Health utility of survivors","value":{"p10":0.6,"p50":0.7,"p90":0.8,"shape":"two-piece-logit","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Downward transfer from 0.799 for HIV-negative daily heroin injection, allowing comorbidity and population differences.","sources":[{"publisher":"Patton et al., Quality of Life Research","title":"Analyzing quality of life among people with opioid use disorder from the NIDA Data Share initiative","url":"https://link.springer.com/article/10.1007/s11136-024-03729-6","published":"2024-08-08","retrieved":"2026-09-07"}],"from":"templates/naloxone-distribution.v1.json"},"annualHazard":{"label":"Annual all-cause mortality hazard after a nonfatal overdose","value":{"p10":0.055,"p50":0.08,"p90":0.15,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"universal","basis":"transferred","rationale":"Central informed by 778.3 deaths per 10,000 person-years in a US overdose-survivor cohort. Note: a higher hazard lowers QALYs, so p90 here is the pessimistic case.","sources":[{"publisher":"Olfson et al., JAMA Psychiatry","title":"Causes of Death After Nonfatal Opioid Overdose","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC6143082/","published":"2018","retrieved":"2026-09-07"},{"publisher":"Weiner et al., Annals of Emergency Medicine","title":"One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose","url":"https://pubmed.ncbi.nlm.nih.gov/31229387/","published":"2020","retrieved":"2026-09-07"}],"from":"templates/naloxone-distribution.v1.json"},"horizonYears":{"label":"Credited survival horizon","value":{"p10":10,"p50":15,"p90":20,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"convention","basis":"judgment","rationale":"Truncates benefits because recipient ages and long-term outcomes are unknown; not a life expectancy.","from":"templates/naloxone-distribution.v1.json"},"discountRate":{"label":"Annual QALY discount rate","value":{"p10":0.03,"p50":0.03,"p90":0.03,"shape":"fixed","basis":"convention"},"scope":"convention","basis":"convention","rationale":"Project-wide 3% convention.","from":"templates/naloxone-distribution.v1.json"},"costPerDose":{"label":"Donor cost per additional dose delivered","value":{"p10":30,"p50":55,"p90":110,"shape":"two-piece-lognormal","basis":"analyst-scenarios"},"scope":"local","basis":"derived","rationale":"$250,000 / 4,541 kits = $55 per kit (2017, city-funded, CRA). Unit is a kit, which may hold more than one dose; template expects doses. Kept per-kit and paired with per-kit reversals so the ratio is consistent. Not inflated to 2026.","sources":[{"publisher":"City of Chicago, Office of the Mayor","title":"Press release on opioid treatment and naloxone funding (July 20, 2017)","url":"https://chicago.gov/city/en/depts/mayor/press_room/press_releases/2017/july/OpioidAddictionTreatment.html","published":"2017-07-20","retrieved":"2026-10-18","locator":"$250,000 city investment; 4,541 kits distributed; 1,544 reversals in the past year. Seen only in a search-result summary; direct fetch returned HTTP 403, so the figures are unverified.","sourceType":"Government press release; stale"}],"from":"parameters/us-il-chicago/naloxone-distribution.json"},"marginalYieldRetention":{"label":"Share of reported reversal yield retained at the margin","value":{"p10":0.25,"p50":0.5,"p90":0.75,"shape":"two-piece-logit","basis":"analyst-scenarios"},"scope":"local","basis":"judgment","rationale":"Transferred unchanged from SF; no Chicago saturation lookup found.","from":"parameters/us-il-chicago/naloxone-distribution.json"},"additionalSurvivalPerReversal":{"label":"Additional acute survivals per retained reversal","value":{"p10":0.005,"p50":0.02,"p90":0.05,"shape":"two-piece-logit","basis":"analyst-scenarios"},"scope":"local","basis":"judgment","rationale":"Transferred unchanged from SF; Chicago EMS response and bystander-naloxone prevalence not looked up.","from":"parameters/us-il-chicago/naloxone-distribution.json"},"reportedReversals":{"label":"Reversals reported by the organization in the reference year","value":{"p10":1544,"p50":1544,"p90":1544,"shape":"fixed","basis":"convention"},"scope":"org","basis":"observed","rationale":"Reversals reported in the year the $250,000 city investment covered. Self-reported peer reversals; possibly not all from city-funded kits.","sources":[{"publisher":"City of Chicago, Office of the Mayor","title":"Press release on opioid treatment and naloxone funding (July 20, 2017)","url":"https://chicago.gov/city/en/depts/mayor/press_room/press_releases/2017/july/OpioidAddictionTreatment.html","published":"2017-07-20","retrieved":"2026-10-18","locator":"$250,000 city investment; 4,541 kits distributed; 1,544 reversals in the past year. Seen only in a search-result summary; direct fetch returned HTTP 403, so the figures are unverified.","sourceType":"Government press release; stale"}],"from":"estimates/us-il-chicago/cra-naloxone.recipe.json"},"reportedDoses":{"label":"Doses distributed by the organization in the same year","value":{"p10":4541,"p50":4541,"p90":4541,"shape":"fixed","basis":"convention"},"scope":"org","basis":"observed","rationale":"Kits, not doses. Kept as kits so it matches the per-kit cost.","sources":[{"publisher":"City of Chicago, Office of the Mayor","title":"Press release on opioid treatment and naloxone funding (July 20, 2017)","url":"https://chicago.gov/city/en/depts/mayor/press_room/press_releases/2017/july/OpioidAddictionTreatment.html","published":"2017-07-20","retrieved":"2026-10-18","locator":"$250,000 city investment; 4,541 kits distributed; 1,544 reversals in the past year. Seen only in a search-result summary; direct fetch returned HTTP 403, so the figures are unverified.","sourceType":"Government press release; stale"}],"from":"estimates/us-il-chicago/cra-naloxone.recipe.json"}},"nativeOutcome":{"unit":"additional opioid-overdose deaths averted","perUnitCost":"additional naloxone dose distributed","outcomesPer10kUsd":{"p10":0.1073,"p50":0.5145,"p90":1.919,"unit":"additional opioid-overdose deaths averted per $10,000","shape":"empirical","basis":"simulated"},"costPerOutcome":{"p10":5212,"p50":19440,"p90":93260,"unit":"USD per additional opioid-overdose deaths averted","shape":"empirical","basis":"simulated"},"centralPoint":16180,"formula":"reversalsPerDose * marginalYieldRetention * additionalSurvivalPerReversal"},"cost":{"currency":"USD","priceYear":2017,"boundary":"average-program"},"qalyLayer":{"bridgeId":"opioid-death-averted-to-qaly","bridgeVersion":"v1","qalysPerNativeOutcome":{"p10":3.325,"p50":4.8,"p90":6.357,"unit":"QALYs per additional opioid-overdose deaths averted","shape":"empirical","basis":"simulated"},"pricePer10Qalys":{"p10":10860,"p50":41750,"p90":204200,"unit":"USD per 10 QALYs","shape":"empirical","basis":"simulated"},"centralPointPricePer10Qalys":31380,"probabilityNonPositive":0,"auditStatus":"unaudited","notes":"probabilityNonPositive is 0 by construction: v1 input distributions are strictly positive, so the null case lives only in nullBoundary."},"simulation":{"method":"monte-carlo-independent","samples":20000,"seed":20261018,"tool":"docs/open-botec/tools/evaluate.mjs","notes":"Inputs drawn independently. Legacy SF scenarios were joint corners; independent draws give a narrower price spread than those corners."},"margin":{"basis":"average-adjusted-to-marginal","adjustments":["marginalYieldRetention"]},"fundingRoom":{"status":"unverified","nextEvidence":"Current CRA doses, reversals, budget and unfunded expansion plan."},"nullBoundary":"If the gift replaces existing provision or reaches no otherwise-fatal events, deaths averted are zero and there is no finite price.","provenance":{"sessions":[{"sessionId":"open-botec-localization-20261018","workerId":"claude-opus-open-botec-design","role":"localization","startedAt":"2026-10-18T18:37:21Z","endedAt":"2026-10-18T18:38:10Z","model":{"id":"claude-opus-5-5","name":"Claude Opus 5.5","evidence":"Runtime system prompt of the open-botec design session"},"evidence":"docs/open-botec/localization-test.md"}],"audits":[]},"conflictOfInterest":{"declared":false,"authorRelationship":"none","selfSubmitted":false}}