Alcohol and Alcoholism Advance Access published online on October 6, 2009
Alcohol and Alcoholism, doi:10.1093/alcalc/agp067
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Methodological Assessment of Economic Evaluations of Alcohol Treatment: What Is Missing?
1 Centre for Health Economics, University of York, UK
2 Department of Health Sciences, University of York, UK
3 HYMS, University of York, UK
* Corresponding author: Centre for Health Economics, Alcuin ‘A’ Block, University of York, Heslington, York YO10 5DD, UK. Tel: +44-1904-321401; Fax: +44-1904-321402; E-mail: cppb500{at}york.ac.uk
Received 15 May 2009; first review notified 22 June 2009; in revised form 3 September 2009; accepted 7 September 2009
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Abstract |
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Aim: The aim of this study is to review the methodology that has been adopted in previous economic evaluations of alcohol treatment and offer research recommendations with a view to enhancing the consistency and harmonization of economic evaluations in the alcohol field. Methods: Published full economic evaluations of alcohol treatment were retrieved using a systematic search. The studies were analysed in terms of the identification, measurement and valuation methods used to assess the society-level consequences and the methods used to carry out the analysis of individual-level consequences and costs of the intervention. A taxonomy of alcohol-related consequences was developed and used as a framework for the methodology extraction. Results: Twenty- seven studies were selected. Almost half of the studies did not include society-level consequences in their analysis. Some consequences of alcohol treatment at a societal level, such as the impact of treatment on health-related quality of life of family and friends of the drinker, have never been considered in the economic analysis. There was no agreement regarding the individual health consequences used in the evaluations. Measures capturing life years and morbidity have not been extensively used in the alcohol field. The level of reporting treatment costs on the reviewed studies is generally well detailed. Conclusion: The literature is still rather sparse in this area and further research is required to fulfil the gaps. If a common methodology is adopted in future economic evaluations of alcohol treatment, more stable cost-effectiveness estimates will be produced and informed decisions for resources allocation to alcohol treatments will be possible.