Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT)

Abstract

Objective To compare the cost effectiveness of social behaviour and network therapy, a new treatment for alcohol problems, with that of the proved motivational enhancement therapy. Design Cost effectiveness analysis alongside a pragmatic randomised trial. Setting Seven treatment sites around Birmingham, Cardiff, and Leeds. Participants 742 clients with alcohol problems; 617 (83.2%) were interviewed at 12 months and full economic data were obtained on 608 (98.5% of 617). Main economic measures Quality adjusted life years (QALYs), costs of trial treatments, and consequences for public sector resources (health care, other alcohol treatment, social services, and criminal justice services). Results Both therapies saved about five times as much in expenditure on health, social, and criminal justice services as they cost. Neither net savings nor cost effectiveness differed significantly between the therapies, despite the average cost of social behaviour and network therapy (£221; $385; €320) being significantly more than that of motivational enhancement therapy (£129). If a QALY were worth £30 000, then the motivational therapy would have 58% chance of being more cost effective than the social therapy, and the social therapy would have 42% chance of being more cost effective than the motivational therapy. Conclusion Participants reported highly significant reductions in drinking and associated problems and costs. The novel social behaviour and network therapy did not differ significantly in cost effectiveness from the proved motivational enhancement therapy.

The female therapist and the client’s gender

“…Matching of therapy methods and clients' characteristics has produced almost no results [14][15][16][17] . Instead, matching focusing on objective characteristics like gender and ethnicity has produced more promising results [18] , but matching in this area, too, has produced somewhat mixed results [19] .…”

AESOPS: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care

“…For instance, the most widely used outcome measurements were drinks per drinking day, binge-drinking episodes or heavy drinking, and percentage of days abstinent. Although some economic evaluations used QALYs as a health outcome measure following NICE's guidance 71,114 none focuses on a similar population or interventions to the AESOPS study.…”

“…71 Utilisation of more specialist services was recorded, including the type of intervention, and costs were applied from previous research trials and a recent Department of Health-funded research project based on a range of specialist providers and intervention types. 72 The incremental cost-effectiveness of stepped care compared with the minimal intervention was assessed from both a health and a personal social services perspective following National Institute for Health and Care Excellence (NICE) guidance 73 and a wider public sector resource perspective.…”

“…73 Utilisation of alcohol services outside the trial protocol, along with all other public sector services, including health, social welfare and contact with criminal justice agencies, was assessed from questionnaires administered at baseline and 6 and 12 months. Units of resource use recorded were multiplied by national sources of unit costs 71,74 in order to provide generalisable results.…”

Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs – a randomised controlled feasibility trial

“…Social behaviour and network therapy is an intervention developed in the UK that has been shown to be effective with harmful drinkers 43 and is recommended in recent NICE guidance. 44 The original SBNT intervention was developed and tested as part of the UK Alcohol Treatment Trial (UKATT) conducted in UK alcohol treatment services.…”