This section of the literature review contains studies which focus on payment by results interventions in the substance misuse sector. The complexity of defining and measuring recovery from addiction makes commissioning substance misuse services via payment by results a challenging enterprise, although there have been successes in the US. For each study, I provide the full reference, a link to the document if available freely online and a one sentence summary. Studies are presented in order of publication; most recent first. Studies which I regard as of high quality or of particular interest are highlighted in bold. You can jump to the seven other sections of research here:


Donmall & Suton (2017) Evaluation of the Drugs and Alcohol Recovery Payment by Results Pilot Programme Final Report My summary here.  The belated final evaluation of the drug and alcohol PbR recovery pilots found they were expensive, delayed treatment entry & had fewer treatment completions.

Mason, T. et al. (2015) The impact of paying treatment providers fir outcomes: difference-in-differences analysis of the payment by results the drugs recovery pilot. Addiction, 110, 1120 – 1128. My summary here.

Large scale evaluation found that treatment completion and retention rates were WORSE for pilot areas.

National Drug Evidence Centre, University of Manchester (2014) Evaluation of the drugs and alcohol recovery payment by results pilot program: interim summary report. Manchester: NDEC. My summary can be found here.

Commissioners and providers have mixed views about PbR; some felt it created opportunities for increased creativity and flexibility, others felt that it was expensive and distorted some aspects of treatment provision.

Social Finance [Lead authors: John Strang and Samantha Gross] (2012) Social Impact Bonds: Enabling long term recovery from addiction. London: Social Finance. You can read my summary here.

Sets out proposed detailed metrics within overall measure of “life progress”; emphasis on long term goals.

Roberts, M. & Singleton, N. (2011) Payment by Results co-design group consultation draft outcomes for piloting PbR for recovery – Joint Response from DrugScope and the UK Drug Policy Commission

Expresses particular concern about the potential for gaming.

Roberts, M. (2011) By their fruits: applying payment by results to drugs recovery. London: UK Drug Policy Commission.

In praise of outcome-based funding, but identifies many of the principal difficulties in applying PbR to substance misuse.

McLellan, A.; Kemp, J.; Brooks, A. & Carise, D. (2008) Improving public addition treatment through performance contracting: The Delaware experiment. Health Policy 87 pp. 296-308.

Well thought-out, simple approach resulted in most providers improving retention and completion rates.