Alcohol Treatment Costs Offset by Long-Term Health Care, Societal Savings

Newswise — Treating people for alcohol use disorder, even multiple times, results in long-term cost savings. When accounting for societal benefits of treatment, such as reduced crime and increased productivity, cost savings are realized in both the short- and long-term. These findings were published in an analysis of the long-term cost-effectiveness of alcohol use disorder treatment published this month in Alcohol: Clinical and Experimental Research. The authors of the study from RTI International, a nonprofit research institute, recommend that policymakers take a long view and factor in reductions in crime and increases in labor productivity when considering policies and practices related to treatment for alcohol use disorder.

For this first-of-its-kind analysis, researchers calculated treatment cost-effectiveness based on one-year, five-year, and lifetime outcomes and outcomes after one, two, four, and unlimited additional courses of treatment after an initial treatment for alcohol use disorder. Cost-effectiveness analyses were conducted from healthcare and societal perspectives and factored in quality of life, multiple alcohol-related conditions, and costs related to healthcare utilization, crime, and productivity in the workforce.

Treatment became more cost-effective when the timeframe examined increased. From a healthcare perspective (i.e., when excluding the cost savings from crime and productivity), and when measured over the lifetime, treatment cost $78 per each additional quality-adjusted life year gained. However, when calculated sooner after treatment, the cost seems much higher: $2,700 if calculated five years after treatment and $56,000 if the timeframe is one year post-treatment.

According to the analysis, multiple courses of treatment, especially unlimited treatment, were very cost-effective. Multiple courses of treatment can help sustain long-term reductions in drinking. People who were treated for alcohol use disorder more than once had lower alcohol-related hospitalizations, which offset most of the healthcare cost of treatment within the first five years and almost entirely offset the cost over their lifetime.

From a societal perspective, additional treatment was more cost-effective at all time points due to reduced crime and alcohol-related hospitalizations and increased labor productivity following treatment for alcohol use disorder.

The analysis was conducted using a validated microsimulation model of long-term drinking patterns of 10,000 simulated individuals, based on people in a previous large U.S. clinical trial who were treated for alcohol use disorder with medication, behavioral therapy, or both. The findings may not be generalizable beyond the population in the original clinical trial, which excluded people with drug use disorder and severe medical and psychiatric conditions. Costs are in year 2020 dollars.

Excessive alcohol use causes about 90,000 deaths annually in the United States. Alcohol use disorder affects eleven percent of the population aged twelve and older. Despite the proven effectiveness of treatment, less than five percent of people with alcohol use disorder receive any treatment. Of those who do, the average person seeks treatment three times, with an average of five years between treatments.

Modeling the impact of a long-term horizon and multiple treatment episodes on estimates of the cost-effectiveness of alcohol treatment in the United States. C. Barbosa, W. Dowd, K. Karriker-Jaffe, G. Zarkin.

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