Economic evaluation of interventions for problem drinking and alcohol dependence: cost per QALY estimates.
OBJECTIVE
To compare the performance of competing and complementary interventions for prevention or treatment of problem drinking and alcohol dependence. To provide an example of how health maximising decision-makers might use performance measures such as cost per quality adjusted life year (QALY) league tables to formulate an optimal package of interventions for problem drinking and alcohol dependence.


METHODS
A time-dependent state-transition model was used to estimate QALYs gained per person for each intervention as compared to usual care in the relevant target population.


RESULTS
Cost per QALY estimates for each of the interventions fall below any putative funding threshold for developed economies. Interventions for problem drinkers appear to offer better value than interventions targeted at those with a history of severe physical dependence.


CONCLUSIONS
Formularies such as Australia's Medicare should include a comprehensive package of interventions for problem drinking and alcohol dependence.
Mortimer
Duncan
D
Centre for Health Economics, Faculty of Business and Economics, Monash University, VIC 3800, Australia. duncan.mortimer@buseco.monash.edu.au
Segal
Leonie
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000427:Alcohol Deterrents / Q000191:economics / Q000627:therapeutic use; D000437:Alcoholism / Q000145:classification / Q000191:economics* / Q000534:rehabilitation*; D001315:Australia; D015928:Cognitive Behavioral Therapy / Q000191:economics; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009042:Motivation; D009629:Person-Centered Psychotherapy / Q000191:economics; D011614:Psychotherapy, Brief / Q000191:economics; D011615:Psychotherapy, Group / Q000191:economics; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation / Q000191:economics*
D000427:Alcohol Deterrents