Estimating the Cost of Preventive Services in Mental Health and Substance Abuse Under Managed Care

Broskowski, Anthony; Smith, S. J. M.

doi:10.1037/e436382005-001

Cited by 7 publications

(8 citation statements)

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“…Although several review articles conclude that SBI is cost-effective [8, 10–11], CEA results vary considerably. This variation reflects the issues underlying the supporting cost analyses, previously discussed, and the fact that many studies use different metrics for outcomes.…”

Section: Economic Evaluation: Methods and Summary Of Evidencementioning

confidence: 99%

“…Furthermore, several review articles have concluded that alcohol SBI is a cost-effective preventive service [8, 10–11], and many policy makers are advocating that SBI be used as part of standard clinical practice (e.g., [12–14]). Despite the widespread perception that SBI is cost-effective, the scientific evidence base supporting this conclusion is relatively weak, and more research is needed before definitive policy recommendations can be made [15].…”

Section: Introductionmentioning

confidence: 99%

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Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

Cowell

Bray

Mills

et al. 2010

Drug and Alcohol Review

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Issues Many policy review articles have concluded that alcohol screening and brief intervention (SBI) is both cost-effective and cost-beneficial. Yet a recent cost-effectiveness review for the United Kingdom’s National Institute for Health and Clinical Excellence suggests that these conclusions may be premature. Approach This article offers a brief synopsis of the various types of economic analyses that may be applied to SBI, including cost analysis, cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, and other types of economic evaluation. A brief overview of methodological issues is provided, and examples from the SBI evaluation literature are provided. Key Findings, Implications, and Conclusions The current evidence base is insufficient to draw firm conclusions about the cost, cost-effectiveness, or cost-benefit of SBI and about the impact of SBI on health care utilisation.

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Section: Economic Evaluation: Methods and Summary Of Evidencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

Cowell

Bray

Mills

et al. 2010

Drug and Alcohol Review

View full text Add to dashboard Cite

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“…There is also broad variability in the costing methodology used in the literature. For example, brief intervention costs have been reported at $2.59 per patient (126), $135 per brief intervention session (128), and $0.59 median per member per month (insurance premium cost) (129). Obviously, the underlying variability of the SBI programs is a primary cause for the variation in cost estimates, but the lack of a consistent costing methodology contributes to the variability and limits the usefulness of crossprogram comparisons.…”

Section: Economic Considerationsmentioning

confidence: 99%

Screening, Brief Intervention, and Referral to Treatment (SBIRT): Toward a Public Health Approach to the Management of Substance Abuse

Babor

McRee

Kassebaum

et al. 2011

FOC

267

345

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Abstract:Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years, including the development of screening tests, clinical trials of brief interventions and implementation research. Beginning in the 1980s, concerted efforts were made in the US and at the World Health Organization to provide an evidence base for alcohol screening and brief intervention in primary health care settings. With the development of reliable and accurate screening tests for alcohol, more than a hundred clinical trials were conducted to evaluate the efficacy and cost effectiveness of alcohol screening and brief intervention in primary care, emergency departments and trauma centers. With the accumulation of positive evidence, implementation research on alcohol SBI was begun in the 1990s, followed by trials of similar methods for other substances (e.g., illicit drugs, tobacco, prescription drugs) and by national demonstration programs in the US and other countries. The results of these efforts demonstrate the cumulative benefit of translational research on health care delivery systems and substance abuse policy. That SBIRT yields shortterm improvements in individuals' health is irrefutable; long-term effects on population health have not yet been demonstrated, but simulation models suggest that the benefits could be substantial.

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“…Several studies reviewing the literature suggest that brief interventions, many of which use MI, can be cost-effective in reducing alcohol use across a number of populations (Broskowski and Smith, 2001;Coffi eld et al, 2001;Cowell et al, 2010;Latimer et al, 2009;Solberg et al, 2008). To our knowledge, however, there are no published economic evaluations of MI for drinking among college students.…”

mentioning

confidence: 99%

Cost-Effectiveness Analysis of Motivational Interviewing With Feedback to Reduce Drinking Among a Sample of College Students

Cowell

Brown

Mills

et al. 2012

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: This study evaluated the costs and costeffectiveness of combining motivational interviewing with feedback to address heavy drinking among university freshmen. Method: Microcosting methods were used in a prospective cost and cost-effectiveness study of a randomized trial of assessment only (AO), motivational interviewing (MI), feedback only (FB), and motivational interviewing with feedback (MIFB) at a large public university in the southeastern United States. Students were recruited and screened into the study during freshman classes based on recent heavy drinking. A total of 727 students (60% female) were randomized, and 656 had suffi cient data at 3-months' follow-up to be included in the cost-effectiveness analysis. Effectiveness outcomes were changes in average drinks per drinking occasion and number of heavy drinking occasions. Results: Mean intervention costs per student were $16.51 for MI, $17.33 for FB, and $36.03 for MIFB. Cost-effectiveness analysis showed two cost-effective interventions for both outcomes: AO ($0 per student) and MIFB ($36 per student). Conclusions: This is the fi rst prospective cost-effectiveness study to our knowledge to examine MI for heavy drinking among students in a university setting. Despite being the most expensive intervention, MIFB was the most effective intervention and may be a cost-effective intervention, depending on a university's willingness to pay for changes in the considered outcomes. (J. Stud. Alcohol Drugs, 73, 226-237, 2012)

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Estimating the Cost of Preventive Services in Mental Health and Substance Abuse Under Managed Care

Cited by 7 publications

References 0 publications

Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

Conducting economic evaluations of screening and brief intervention for hazardous drinking: Methods and evidence to date for informing policy

Screening, Brief Intervention, and Referral to Treatment (SBIRT): Toward a Public Health Approach to the Management of Substance Abuse

Cost-Effectiveness Analysis of Motivational Interviewing With Feedback to Reduce Drinking Among a Sample of College Students

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