The Effect of Alcohol Treatment on Social Costs of Alcohol Dependence: Results From the COMBINE Study
Open accessAbstract
BACKGROUND: The COMBINE (combined pharmacotherapies and behavioral intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the effect of alcohol interventions on broader social costs and outcomes. OBJECTIVES: To estimate the sum of treatment costs plus the costs of health care utilization, arrests, and motor vehicle accidents for the 9 treatments in COMBINE 3 years postrandomization. RESEARCH DESIGN: A cost study based on a randomized controlled clinical trial. SUBJECTS: : The study involved 786 participants 3 years postrandomization. RESULTS: Multivariate results show no significant differences in mean costs between any of the treatment arms as compared with medical management (MM) + placebo for the 3-year postrandomization sample. The median costs of MM + acamprosate, MM + naltrexone, MM + acamprosate + naltrexone, and MM + acamprosate + combined behavioral intervention were significantly lower than the median cost for MM + placebo. CONCLUSIONS: The results show that social cost savings are generated relative to MM + placebo by 3 years postrandomization, and the magnitude of these cost savings is greater than the costs of the COMBINE treatment received 3 years prior. Our study suggests that several alcohol treatments may indeed lead to reduced median social costs associated with health care, arrests, and motor vehicle accidents.
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Several forms of alcohol treatment are cost-effective and improve clinical outcomes.
“various forms of alcohol treatment are cost-effective and improve clinical outcomes (8–15).”
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- Authors
- Zarkin, G. A., Bray, J. W., Aldridge, A., Mills, M., Cisler, R. A., Couper, D., McKay, J. R., & O'Malley, S.
- Affiliations
- RTI International (US)
- Aurora Health Care (US)
- University of North Carolina at Chapel Hill (US)
- Philadelphia VA Medical Center (US)
- Corresponding author
- Zarkin, Gary A.
- Bray, Jeremy W.
- Aldridge, Arnie
- Mills, Michael
- ORCID
- Venue
- Medical Care
- Published
- 2010-05
- Volume
- 48
- Issue
- 5
- Pages
- 396-401
- ISSN
- 0025-7079 (ISSN-L)
- PMC
- PMC3130073
- OpenAlex
- W2007682348
- Cited by
- 42
- References
- 17
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 2 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 2 · 2012: 5
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (K05014715)
- National Institute on Alcohol Abuse and Alcoholism (1-R01-AA12788, R01AA012788)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- alcoholism, social costs, acamprosate, naltrexone, arrests, motor vehicle accidents, health care utilization, cost reduction
- MeSH terms
- Accidents, Traffic, Acamprosate, Alcohol Deterrents, Behavior Therapy, Costs and Cost Analysis, Crime, Health Services, Humans, Naltrexone, Taurine, Alcohol-Related Disorders
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