TY - JOUR
T1 - The cost-effectiveness of the integration of nalmefene within the UK healthcare system treatment pathway for alcohol dependence
AU - Laramée, Philippe
AU - Bell, Melissa
AU - Irving, Adam
AU - Brodtkorb, Thor Henrik
N1 - Publisher Copyright:
© The Author 2015. Medical Council on Alcohol and Oxford University Press.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Aims: To assess the cost-effectiveness of integrating nalmefene within the treatment pathway for alcohol dependence recommended by the National Institute for Health and Care Excellence in the UK. Methods: AMarkovmodel, taking a UK NHS perspective, followed a cohort with alcohol dependence and high/very high drinking risk levels (HVHDRLs), who do not require immediate detoxification and who continue at HVHDRLs after initial assessment, for 5 years. Costs and quality-adjusted life years (QALYs) from treatment with nalmefene plus psychosocial support versus psychosocial support alone were modelled. The consequent incidence of alcohol-attributable harmful events and disease progression, with the possibility of requiring other options or recurrent treatment, were captured. Results: Nalmefene plus psychosocial support dominated psychosocial support alone, with lower costs and increased QALYs after 5 years. Savings are driven by the higher response to nalmefene, and the subsequent lower cost accumulation for alternatives. Conclusions: Nalmefene represents a highly cost-effective treatment option in this population. The analysis shows that integrating nalmefene within the current UK clinical treatment pathway for alcohol dependence could reduce the economic burden on the NHS by limiting harmful events and disease progression.
AB - Aims: To assess the cost-effectiveness of integrating nalmefene within the treatment pathway for alcohol dependence recommended by the National Institute for Health and Care Excellence in the UK. Methods: AMarkovmodel, taking a UK NHS perspective, followed a cohort with alcohol dependence and high/very high drinking risk levels (HVHDRLs), who do not require immediate detoxification and who continue at HVHDRLs after initial assessment, for 5 years. Costs and quality-adjusted life years (QALYs) from treatment with nalmefene plus psychosocial support versus psychosocial support alone were modelled. The consequent incidence of alcohol-attributable harmful events and disease progression, with the possibility of requiring other options or recurrent treatment, were captured. Results: Nalmefene plus psychosocial support dominated psychosocial support alone, with lower costs and increased QALYs after 5 years. Savings are driven by the higher response to nalmefene, and the subsequent lower cost accumulation for alternatives. Conclusions: Nalmefene represents a highly cost-effective treatment option in this population. The analysis shows that integrating nalmefene within the current UK clinical treatment pathway for alcohol dependence could reduce the economic burden on the NHS by limiting harmful events and disease progression.
UR - http://www.scopus.com/inward/record.url?scp=84965008559&partnerID=8YFLogxK
U2 - 10.1093/alcalc/agv140
DO - 10.1093/alcalc/agv140
M3 - Article
C2 - 26825639
AN - SCOPUS:84965008559
SN - 0735-0414
VL - 51
SP - 283
EP - 290
JO - Alcohol and Alcoholism
JF - Alcohol and Alcoholism
IS - 3
ER -