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Randomized Controlled Trial
. 2019 May:100:1-7.
doi: 10.1016/j.jsat.2019.02.001. Epub 2019 Feb 7.

Cost-effectiveness of individual versus group female-specific cognitive behavioral therapy for alcohol use disorder

Todd A Olmstead  1 , Fiona S Graff  2 , Alyssa Ames-Sikora  3 , Barbara S McCrady  4 , Ayorkor Gaba  5 , Elizabeth E Epstein  6
Affiliations
Randomized Controlled Trial

Cost-effectiveness of individual versus group female-specific cognitive behavioral therapy for alcohol use disorder

Todd A Olmstead et al. J Subst Abuse Treat. 2019 May.

Abstract

Objective: To determine the relative cost-effectiveness of individual female-specific cognitive behavioral therapy (I-FS-CBT) versus group female-specific cognitive behavioral therapy (G-FS-CBT).

Methods: This cost-effectiveness study is based on a randomized controlled trial in which 155 women seeking treatment for alcohol use disorder at an academic outpatient clinic were randomized to 12 manual-guided sessions of I-FS-CBT (n = 75) or G-FS-CBT (n = 80). The primary patient outcomes were the number of drinking days and the number of heavy drinking days during the 12-week treatment and 1-year follow-up periods. All cost data (including resource utilizations) were collected prospectively alongside the trial. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves were used to determine the cost-effectiveness of I-FS-CBT relative to G-FS-CBT. Results are presented from the provider perspective.

Results: During the 12-week treatment period, G-FS-CBT is likely to be cost-effective when the threshold value to decision-makers of one fewer drinking day (or one fewer day of heavy drinking) is less than $141 (or $258), and I-FS-CBT is likely to be cost-effective if the threshold is greater than $141 (or $258). During the 1-year follow-up period, G-FS-CBT is likely to be cost-effective when the threshold value to decision-makers of one fewer drinking day (or one fewer day of heavy drinking) is less than $54 (or $169), and I-FS-CBT is likely to be cost-effective if the threshold is greater than $54 (or $169). The results are robust to sensitivity analyses on several key cost parameters.

Conclusions: Compared to I-FS-CBT, G-FS-CBT holds promise as a cost-effective approach, in both the short run and the long run, for improving drinking outcomes of women with alcohol use disorder.

Keywords: Alcohol use disorder; Cognitive behavioral therapy; Cost effectiveness; Female specific therapy; Women.

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Conflict of interest statement

Declarations of Interest: None

Figures

Figure 1.
Figure 1.
Cost-effectiveness acceptability curves showing the probability that I-FS-CBT is cost-effective, compared to G-FS-CBT, for ‘number drinking days’ and ‘number of heavy drinking days’ during the (a) 12-week treatment period, and (b) 1-year follow-up period. For a given threshold value, the probability that I-FS-CBT is cost-effective compared to G-FS-CBT is equivalent to the proportion of the 2000 bootstrapped replicates for which I-FS-CBT had the highest net benefit (Fenwick, Claxton, & Schulpher, 2001)
See this image and copyright information in PMC

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