title: The cost effectiveness of naltrexone added to cognitive-behavioral therapy in the treatment of alcohol dependence.
abstract: The purpose of this study was to evaluate the comparative cost of treating alcohol dependence with either cognitive behavioral therapy (CBT) alone or CBT combined with naltrexone (CBT+naltrexone). Two hundred ninety-eight outpatients dependent on alcohol who were consecutively treated for alcohol dependence participated in this study. One hundred seven (36%) patients received adjunctive pharmacotherapy (CBT+naltrexone). The Drug Abuse Treatment Cost Analysis Program was used to estimate treatment costs. Adjunctive pharmacotherapy (CBT+naltrexone) introduced an additional treatment cost and was 54% more expensive than CBT alone. When treatment abstinence rates (36.1% CBT; 62.6% CBT+naltrexone) were applied to cost effectiveness ratios, CBT+naltrexone demonstrated an advantage over CBT alone. There were no differences between groups on a preference-based health measure (SF-6D). In this treatment center, to achieve 100 abstainers over a 12-week program, 280 patients require CBT compared with 160 CBT+naltrexone. The dominant choice was CBT+naltrexone based on modest economic advantages and significant efficiencies in the numbers needed to treat.
authors.affiliation: Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Queensland, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Walters
authors.forename: Jason P
authors.initials: JP
authors.lastname: Connor
authors.forename: Gerald F X
authors.initials: GF
authors.lastname: Feeney
authors.forename: Ross McD
authors.initials: RM
authors.lastname: Young