[Adjuvant drug treatment of alcoholism with acamprosate: between sectoral budgets and disease management].
OBJECTIVE
On the basis of several controlled clinical investigations the cost-effectiveness of acamprosate as adjuvant therapy of alcohol-dependent patients has yet been evaluated. These optimal conditions cannot be found in the daily ambulant practice and results in asking which of the alternatives, "standard plus acamprosate" or "standard without acamprosate", is more cost-effective in maintaining abstinence in alcohol dependent patients under realistic conditions.


METHODS
In an open multi-centre study, medical care, costs and therapeutic outcome was prospectively documented. Prior to enrolling, all patients were obliged to undergo a detoxification procedure. At a mean age of 45 years the patients suffered an average of ten years from alcohol dependence. 521 patients were documented in the acamprosate cohort and 265 patients in the cohort "other therapy" over one year. Two thirds of the participating patients were male.


RESULTS
At 33.6 % the rate of abstinence was remarkably higher in the acamprosate cohort in comparison to the cohort "other" at 21.1 % abstinent patients. The mean total costs per patient and year amounted to DM 3191 in the acamprosate-cohort and were significantly lower than in the cohort "other" with DM 4046. Effectiveness-adjusted costs of DM 9500 per successfully treated patient in the acamprosate-cohort were superior to the cohort "other", amounting to DM 19 148 per successfully treated patient.


CONCLUSIONS
The described economic benefits may be utilised under conditions of an adequate disease management.
Rychlik
R
R
Institut für Empirische Gesundheitsökonomie, Burscheid. instfeg@t-online.de
Paschen
B
B
Kirchhoff
D
D
Daniel
D
D
Pfeil
T
T
Kilburg
A
A
D000077443:Acamprosate; D000328:Adult; D000427:Alcohol Deterrents / Q000191:economics / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy* / Q000191:economics / Q000534:rehabilitation*; D002017:Budgets; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D013654:Taurine / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use*; D013695:Temperance / Q000191:economics / Q000706:statistics & numerical data
D000427:Alcohol Deterrents; D013654:Taurine; D000077443:Acamprosate
Die adjuvante Arzneimitteltherapie der Alkoholkrankheit mit Acamprosa--Zwischen sektoraler Budgetierung und Disease Management.