Alcohol and drug abuse impose significant costs on society. In 1992, the economic cost of alcohol and drug abuse was estimated to be 246 billion dollars. The majority of these costs arise from alcohol abuse (148 billion dollars). Partly in response to these costs, new pharmacotherapies have recently been developed to treat alcohol abuse and alcoholism. Likewise, important advances have been made in the development of behavioral interventions designed to treat alcohol abuse. While new alcohol abuse therapies have been developed over the last several years, pressures have been developing to identify therapies that are not only efficacious but also cost-effective. Much of this pressure has been driven by managed care, which has placed a premium on economic studies that assess whether the clinical and economic outcomes of new pharmaceutical and behavioral therapies justify their costs. To increase the understanding of the efficacy of two pharmacotherapies (naltrexone and acamprosate) and psychotherapy, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently funded Project COMBINE, a multi-site, randomized control trial (RCT). This trial is one of the most ambitious clinical trials ever undertaken for the treatment of alcoholism. However, in spite of the importance of economic analysis of clinical trials, the Project COMBINE protocol does not include cost or cost-effectiveness studies. The purpose of this study is to examine the costs and cost-effectiveness of behavioral and pharmacotherapies for alcoholism (and their combination) included in Project COMBINE. Our proposed project builds on Project COMBINE's RCT design, which will provide great credibility of our results in the scientific community. Because of the number of therapies studied, the strength of the study design, and the limited existing literature on the cost and cost-effectiveness of alcohol treatments, the proposed study represents a major advance in the cost and cost-effectiveness analysis of alcohol treatment; our results should have a profound effect on the choice of alcohol treatment in the United States.
| Zarkin, Gary A; Bray, Jeremy W; Aldridge, Arnie et al. (2010) The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study. Med Care 48:396-401 |
| Dunlap, Laura J; Zarkin, Gary A; Bray, Jeremy W et al. (2010) Revisiting the cost-effectiveness of the COMBINE study for alcohol dependent patients: the patient perspective. Med Care 48:306-13 |
| Bray, Jeremy W; Loomis, Brett R; Engelen, Mark (2009) You save money when you buy in bulk: does volume-based pricing cause people to buy more beer? Health Econ 18:607-18 |
| Zweben, Allen; Fucito, Lisa M; O'Malley, Stephanie S (2009) Effective Strategies for Maintaining Research Participation in Clinical Trials. Drug Inf J 43: |
| Zarkin, Gary A; Bray, Jeremy W; Aldridge, Arnie et al. (2008) Cost and cost-effectiveness of the COMBINE study in alcohol-dependent patients. Arch Gen Psychiatry 65:1214-21 |
| Bray, Jeremy W; Loomis, Brett; Engelen, Mark (2007) Correlates of in-store promotions for beer: differential effects of market and product characteristics. J Stud Alcohol Drugs 68:220-7 |
| Bray, Jeremy W; Zarkin, Gary A; Miller, William R et al. (2007) Measuring economic outcomes of alcohol treatment using the Economic Form 90. J Stud Alcohol Drugs 68:248-55 |
| Bray, Jeremy W; Zarkin, Gary A (2006) Economic evaluation of alcoholism treatment. Alcohol Res Health 29:27-33 |
| Zarkin, Gary A; Bray, Jeremy W; Mitra, Debanjali et al. (2005) Cost methodology of COMBINE. J Stud Alcohol Suppl :50-5; discussion 33 |
| Zarkin, Gary A; Bray, Jeremy W; Babor, Thomas F et al. (2004) Alcohol drinking patterns and health care utilization in a managed care organization. Health Serv Res 39:553-70 |
