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Cited by 187Substance Abuse Treatment and OutcomesHealth Systems, Economic Evaluations, Quality of LifeAlcohol Consumption and Health Effects

The cost-effectiveness of treatment for alcoholism: a second approximation.

Finney, J W, Monahan, S C·1996·Journal of Studies on Alcohol
DOI 10.15288/jsa.1996.57.229
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Abstract

OBJECTIVE: This review builds on the innovative research synthesis of Holder and his colleagues, addresses some of the limitations of the box-score approach to assessing treatment effectiveness that they used and provides a second approximation of the cost-effectiveness of treatment for alcoholism. METHOD: For each of 141 comparative treatment studies, we determined whether or not it found at least one statistically significant positive effect on a drinking-related outcome variable for each of the modalities examined in a paired contrast with one other condition. We next calculated the predicted probability of each study yielding at least one statistically significant treatment effect, based on the number of tests for treatment effects conducted. Following that, for each study of a particular treatment modality, the strength of the "weakest competitor" against which the modality had been compared was determined. For each modality, we used the average predicted probability of the relevant studies finding a significant effect and the average effectiveness of the weakest competitor to predict the modality's effectiveness. RESULTS: We calculated an Adjusted Effectiveness Index (AEIn) for each modality, which was the difference between its predicted and actual effectiveness score. Our AEIn results were consistent with those of Holder et al. in suggesting that some of the same modalities appear to be effective or ineffective. Our results differed from their findings with respect to other modalities, however. Using data presented by Holder and his colleagues on the minimum estimated cost of providing different modalities, we offer a second approximation of the modalities' cost-effectiveness. CONCLUSIONS: Overall, we found a smaller range of effectiveness across modalities than did Holder and his colleagues and a nonsignificant relationship between cost and effectiveness. Like Holder et al., we do not believe major treatment provision or funding decisions should be based solely on this type of review.

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  • Low uptake of family treatments for substance use disorders is due to the limited economic evaluations of such treatments.

    “Family treatments for substance use disorders have low uptake in service systems, due to financing barriers for interventions that focus on people other than the identified patient [56] and the limited economic evaluations of such treatments [57].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [57]

  • Family treatments for substance use disorders have low uptake in service systems.

    “Family treatments for substance use disorders have low uptake in service systems, due to financing barriers for interventions that focus on people other than the identified patient [56] and the limited economic evaluations of such treatments [57].”

    From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [57]

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Authors
Finney, J. W., & Monahan, S. C.
Affiliations
VA Palo Alto Health Care System (US)
Venue
Journal of Studies on Alcohol
Publisher
Alcohol Research Documentation, Inc.
Published
1996-05
Volume
57
Issue
3
Pages
229-243
ISSN
  • 0096-882X (ISSN-L)
  • 1934-2683
DOI
10.15288/jsa.1996.57.229
OpenAlex
W2036704426
Cited by
186
References
15
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 7
FWCI
8.29
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Studies on Alcohol (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (R01AA008689, AA08689)
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 treatment, cost-effectiveness, treatment effectiveness, multiple comparisons, treatment costs
MeSH terms
Alcoholism, Cost-Benefit Analysis, Humans, Random Allocation, Health Care Costs

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