Supervised injection facilities (SIFs) or supervised consumption rooms are a component of harm reduction strategies that attempt to reduce drug overdoses and risky injection behaviors among injection drug users. The purpose of this study is to determine whether expanding SIFs into the City of Toronto, Ontario, would be a fiscally responsible decision. By analyzing secondary data gathered in 2013, this article relies on mathematical models to estimate the number of new HIV and hepatitis C virus infections prevented as a result of SIF locations in Toronto. After factoring in the costs associated with SIFs, the models produce cost–benefit and cost-effectiveness outputs. With very conservative estimates, it is predicted that establishing SIF locations in Toronto is cost effective with an average benefit–cost ratio of 1:1.2 for the first two facilities based on the sensitivity analysis at 30% sharing rate. Consequently, funding SIFs in Canada’s largest city appears to be an efficient and effective use of financial resources in the public health domain with cost savings in excess of CAN$728,620 per year for the first two facilities.
