Shatterproof

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.

Domestic treatment-navigation health; g=.99 subjective resident share. No overseas or territorial benefits counted. State footprint is not multiplied by national population.

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.

C

52809073 USD annual full recipient resource cost (observed). 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. [shat-audit24]

U

1200000 annual Atlas users (observed). 2025 report says more than 1.2 million people; use rounded floor, not unique patients or starts. [shat-impact25]

f

0.06622091648937967 profile engagements per user (judgment). Florida quarter 1,961 profile views / 29,613 users = .06622. Transport to national annual population is subjective; repeat views and national mix could differ. [shat-florida]

o

0.2 OUD-relevant fraction of profile engagements (judgment). 20% reserves most engagements for alcohol/other disorders, caregivers or irrelevant contacts; not measured Atlas case mix.

e

0.03 net additional effective treatment starts per OUD engagement (judgment). 3% after non-enrollment, inappropriate capacity, alternative locators and treatment that would happen anyway. A weak prior, not a measured Atlas effect; test zero. [shat-florida] [shat-resources]

t

0.25 additional retained treatment years per start (judgment). 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. [shat-moud]

b

0.5 marginal funding additionality (judgment). 50% allows replacement of other donations, reserves and public contracts. This is separate from patients finding care anyway in e. [shat-audit24]

d

0.01 net deaths prevented per additional treatment-year (judgment). 1% between historical buprenorphine and methadone cohort rate gaps; discounts confounding and modern transport, includes induction/discontinuation risks rather than using peak untreated risk. [shat-moud]

q

15 discounted QALYs per premature death prevented (judgment). 15, broadly about 30 remaining years at .77 utility and 3% discount; not patient-level survival evidence. Test 10–20.

w

0.05 nonfatal QALYs per additional treatment-year (judgment). Small .05 utility improvement while retained, separately from mortality. Could be zero/negative; no long-term recovery dividend.

g

0.99 50-state/DC resident share of modeled health (judgment). 99% for domestic navigation, allowing nonresident use. Not inferred from headquarters or a claim all online users are residents.

h

0 other net health harm per annual activity cohort before funding additionality (judgment). Net zero centrally for unpriced prevention, stigma, policy and adverse effects; not established zero or a proven lower bound.

Weak-confidence best estimate: Cost: $52.8M; USA QALYs: 11.800567318407458; all-population QALYs: 11.91976496808834. {"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.

Much stronger treatment conversion and retention: Cost: $52.8M; USA QALYs: 2851.2; all-population QALYs: 2880. {"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.

Almost no additional effective treatment: Cost: $52.8M; USA QALYs: 0.0010692; all-population QALYs: 0.00108. {"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.

Excludes recognized donated resources from numerator: Cost: $21.5M; USA QALYs: 11.800567318407458; all-population QALYs: 11.91976496808834. {"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.

No net treatment change: Cost: $52.8M; USA QALYs: 0; all-population QALYs: 0. {"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.

No treatment benefit plus 10 QALYs other harm: Cost: $52.8M; USA QALYs: -4.95; all-population QALYs: -5. {"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.

25 QALYs other net harm: Cost: $52.8M; USA QALYs: -0.5744326815925426; all-population QALYs: -0.5802350319116591. {"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.

Only 10% additional capacity: Cost: $52.8M; USA QALYs: 2.3601134636814916; all-population QALYs: 2.3839529936176684. {"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.

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.

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.

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.

Unresolved inputs

• 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.