A Literature Review of Cost-Benefit Analyses for the Treatment of Alcohol Dependence

Svetlana Popova,Jürgen Rehm,Satya Mohapatra,Jayadeep Patra,Amy Duhig

doi:10.3390/ijerph8083351

Abstract

The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD). A literature search was performed in multiple electronic bibliographic databases. The search identified seven psychotherapy studies from the USA and two pharmacotherapy studies from Europe. In the psychotherapy studies, major benefits are typically seen within the first six months of treatment. The benefit-cost ratio ranged from 1.89 to 39.0. Treatment with acamprosate was found to accrue a net benefit of 21,301 BEF (528 €) per patient over a 24-month period in Belgium and lifetime benefit for each patient in Spain was estimated to be Pta. 3,914,680 (23,528 €). To date, only a few studies exist that have examined the cost-benefit of psychotherapy or pharmacotherapy treatment of AD. Most of the available treatment options for AD appear to produce marked economic benefits.

Highlights

There are many types of treatment for alcohol dependence (AD), including psychosocial support groups such as Alcoholics Anonymous, inpatient and outpatient treatment, psychological interventions, pharmacological treatment, employee assistance programs (EAPs) and most typically, a combination of the aforementioned [1,2]
Of AD treatment, the data were extracted from nine articles providing original studies on the cost-benefit of AD treatment: seven psychotherapy studies from USA and two pharmacotherapy studies from Europe
61 studies identified for further screening for cost-benefit analysis of AD treatment

Summary

Introduction

There are many types of treatment for alcohol dependence (AD), including psychosocial support groups such as Alcoholics Anonymous, inpatient and outpatient treatment, psychological interventions, pharmacological treatment, employee assistance programs (EAPs) and most typically, a combination of the aforementioned [1,2]. Pertaining to pharmacotherapies, the U.S Food and Drug Administration (FDA) has approved four pharmacologic agents for the treatment of AD to date: disulfiram, oral naltrexone, injectable long-acting naltrexone, and acamprosate. Disulfiram, an aversive agent, has been used to treat AD for more than 50 years; the evidence for its effectiveness is weak It has significant adverse effects and there is not sufficient evidence that it increases abstinence rates, decreases relapse rates, or reduces cravings [6]. Over 20 clinical trials, as well as meta-analytic reviews support a modest effect of oral naltrexone, and support its effect on reducing heavy drinking, increasing abstinence rates and decreasing alcohol cravings in a number of study populations (e.g., [7,8,9]). Reductions in the number of drinking days and heavy drinking days have been reported; similar to oral Naltrexone, the effects are small [10]

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