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The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study. Med Care 2010 May;48(5):396-401



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Scopus ID

2-s2.0-77951621526 (requires institutional sign-in at Scopus site)   38 Citations


BACKGROUND: The COMBINE (combined pharmacotherapies and behavioral intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the effect of alcohol interventions on broader social costs and outcomes.

OBJECTIVES: To estimate the sum of treatment costs plus the costs of health care utilization, arrests, and motor vehicle accidents for the 9 treatments in COMBINE 3 years postrandomization.

RESEARCH DESIGN: A cost study based on a randomized controlled clinical trial.

SUBJECTS: : The study involved 786 participants 3 years postrandomization.

RESULTS: Multivariate results show no significant differences in mean costs between any of the treatment arms as compared with medical management (MM) + placebo for the 3-year postrandomization sample. The median costs of MM + acamprosate, MM + naltrexone, MM + acamprosate + naltrexone, and MM + acamprosate + combined behavioral intervention were significantly lower than the median cost for MM + placebo.

CONCLUSIONS: The results show that social cost savings are generated relative to MM + placebo by 3 years postrandomization, and the magnitude of these cost savings is greater than the costs of the COMBINE treatment received 3 years prior. Our study suggests that several alcohol treatments may indeed lead to reduced median social costs associated with health care, arrests, and motor vehicle accidents.

Author List

Zarkin GA, Bray JW, Aldridge A, Mills M, Cisler RA, Couper D, McKay JR, O'Malley S


Ron Cisler PhD Professor in the Health Informatics & Administration, Public Health department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Accidents, Traffic
Alcohol Deterrents
Alcohol-Related Disorders
Behavior Therapy
Costs and Cost Analysis
Health Services