BMJ. 2005 Sep 10;331(7516):544. doi: 10.1136/bmj.331.7516.544.
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.
Cost effectiveness analysis alongside a pragmatic randomised trial.
Seven treatment sites around Birmingham, Cardiff, and Leeds.
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).
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 pounds sterling; 385 dollars; 320 euros) being significantly more than that of motivational enhancement therapy (129 pounds sterling). If a QALY were worth 30,000 pounds sterling, 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.
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.
比较社会行为与网络疗法(一种治疗酒精问题的新疗法)和已证实有效的动机增强疗法的成本效益。
成本效益分析与一项实用随机试验同步进行。
伯明翰、加的夫和利兹周边的七个治疗地点。
742名有酒精问题的客户;617名(83.2%)在12个月时接受了访谈,并获取了608名(617名的98.5%)的完整经济数据。主要经济指标 质量调整生命年(QALYs)、试验治疗成本以及对公共部门资源(医疗保健、其他酒精治疗、社会服务和刑事司法服务)的影响。
两种疗法在医疗、社会和刑事司法服务方面节省的支出均约为其成本的五倍。尽管社会行为与网络疗法的平均成本(221英镑;385美元;320欧元)显著高于动机增强疗法(129英镑),但两种疗法在净节省或成本效益方面均无显著差异。如果一个质量调整生命年价值30000英镑,那么动机疗法比社会疗法更具成本效益的概率为58%,而社会疗法比动机疗法更具成本效益的概率为42%。
参与者报告饮酒及相关问题和成本显著降低。新型社会行为与网络疗法在成本效益方面与已证实有效的动机增强疗法无显著差异。