Schädlich P K, Brecht J G
InForMed Gesellschaft für interdisziplinäre Forschung und Beratung im Gesundheitswesen mbH, Hamburg, Germany.
Pharmacoeconomics. 1998 Jun;13(6):719-30. doi: 10.2165/00019053-199813060-00008.
Alcoholism places a considerable economic burden on society. The rate of relapse of previously weaned alcoholics has been shown to decrease following treatment with acamprosate. Therefore, this study investigated the cost effectiveness of acamprosate in the treatment of alcoholism in Germany from the perspective of the German healthcare system. In this retrospective analysis of clinical data, the additional direct medical costs per additional abstinent alcoholic incurred by adjuvant acamprosate therapy of previously weaned alcoholics were quantified. In the base-case analysis, average case-related direct costs were applied. The cost-effectiveness ratio was -2600 deutschmarks (DM) per additional abstinent patient. Thus, the administration of acamprosate is cost saving. The cost benefit of acamprosate was also shown in a sensitivity analysis. The variance of the target variable under 'real world' conditions was simulated and the impact of the model variables on the target variable was quantified using a deterministic model. The variance was broad and the rate of abstinence under acamprosate was the independent variable with the greatest impact on the target variable. From the perspective of both the German healthcare system (i.e. direct medical costs) and the Statutory Health Insurance expenses, adjuvant acamprosate therapy led to net savings, while at the same time improved the patient's state of health. Based on the naturalistic design of the underlying clinical trial and on this economic evaluation, it can be concluded that adjuvant acamprosate therapy leads to net savings under 'real world' conditions.
酒精中毒给社会带来了相当大的经济负担。已证明，对于之前已戒酒的酗酒者，使用阿坎酸治疗后复发率会降低。因此，本研究从德国医疗保健系统的角度调查了阿坎酸治疗德国酒精中毒的成本效益。在这项临床数据的回顾性分析中，对之前已戒酒的酗酒者辅助使用阿坎酸治疗后每新增一名戒酒者所产生的额外直接医疗费用进行了量化。在基础案例分析中，采用了平均病例相关直接成本。成本效益比为每新增一名戒酒患者节省2600德国马克（DM）。因此，使用阿坎酸具有成本节约效果。敏感性分析也显示了阿坎酸的成本效益。模拟了“现实世界”条件下目标变量的方差，并使用确定性模型量化了模型变量对目标变量的影响。方差范围很广，阿坎酸治疗下的戒酒率是对目标变量影响最大的自变量。从德国医疗保健系统（即直接医疗成本）和法定医疗保险费用的角度来看，辅助使用阿坎酸治疗可带来净节省，同时改善了患者的健康状况。基于基础临床试验的自然设计以及这项经济评估，可以得出结论，在“现实世界”条件下，辅助使用阿坎酸治疗可带来净节省。
