Flores Sergio, Jónsson-Bachmann Egill, Ingesson-Hammarberg Stina, Hammarberg Anders, Nystrand Camilla, Sampaio Filipa
Department of Public Health and Caring Sciences (IFV), Uppsala University, BMC, Husargatan 3, Uppsala, 751 22, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Cost Eff Resour Alloc. 2025 Jun 2;23(1):24. doi: 10.1186/s12962-025-00633-9.
In Sweden, up to 7% of people exhibit harmful alcohol use or dependency, but only a small fraction (10–20%) pursue treatment. While Behavioral Self-Control Training (BSCT) and Motivational Enhancement Therapy (MET) are effective for alcohol use disorders (AUD), their cost-effectiveness has not been studied. This research evaluates the cost-effectiveness of BSCT and MET in treating AUD, focusing on achieving controlled drinking from both a healthcare and limited societal perspective.
DESIGN, SETTING, AND PARTICIPANTS: A Markov model was created to compare the cost-effectiveness of BSCT and MET for treatment-seeking individuals with AUD. This model simulated a sample of patients with AUD over five years, calculating the costs and outcomes for both treatments. It used a cost-utility analysis to determine the cost per quality-adjusted life year (QALY). The model accounted for varying levels of alcohol intake and related health complications. Efficacy data came from a randomized trial, with complication risks, costs, utilities, and mortality rates drawn from existing literature.
BSCT, consisting of five sessions, was compared to MET, constituted by four sessions.
The primary outcome was cost per QALY. Probabilistic and univariate sensitivity analyses were performed to estimate how parameter uncertainty affected model outputs.
BSCT proved less costly than MET, yielding savings in healthcare costs by $50.52 and societal costs by $118.12 on average per person. Additionally, BSCT demonstrated an advantage in QALYs, with a gain of 0.060 QALYs per patient over MET. Sensitivity analyses confirmed the robustness of these results, indicating that BSCT is the cost-effective treatment option.
In comparison to MET, BSCT is less costly and more beneficial for health, indicating its potential as a valuable treatment option for individuals with AUD targeting controlled drinking. The model can be applied to assess the cost-effectiveness of various other AUD treatment interventions.
The online version contains supplementary material available at 10.1186/s12962-025-00633-9.
在瑞典，高达7%的人存在有害饮酒行为或酒精依赖，但只有一小部分人（10%-20%）寻求治疗。虽然行为自我控制训练（BSCT）和动机增强疗法（MET）对酒精使用障碍（AUD）有效，但其成本效益尚未得到研究。本研究评估了BSCT和MET治疗AUD的成本效益，重点从医疗保健和有限的社会角度实现适度饮酒。
设计、背景与参与者：创建了一个马尔可夫模型，以比较BSCT和MET对寻求治疗的AUD个体的成本效益。该模型模拟了一组AUD患者五年的情况，计算了两种治疗方法的成本和结果。它使用成本效用分析来确定每质量调整生命年（QALY）的成本。该模型考虑了不同水平的酒精摄入量和相关健康并发症。疗效数据来自一项随机试验，并发症风险、成本、效用和死亡率来自现有文献。
将由五个疗程组成的BSCT与由四个疗程组成的MET进行比较。
主要结果是每QALY的成本。进行了概率和单变量敏感性分析，以估计参数不确定性如何影响模型输出。
事实证明，BSCT的成本低于MET，平均每人可节省医疗保健成本50.52美元和社会成本118.12美元。此外，BSCT在QALY方面表现出优势，每位患者比MET多获得0.060个QALY。敏感性分析证实了这些结果的稳健性，表明BSCT是具有成本效益的治疗选择。
与MET相比，BSCT成本更低且对健康更有益，表明其作为针对适度饮酒的AUD个体的有价值治疗选择的潜力。该模型可用于评估各种其他AUD治疗干预措施的成本效益。
在线版本包含可在10.1186/s12962-025-00633-9获取的补充材料。
