TY - JOUR PY - 2016// TI - Cost-effectiveness of an internet-delivered treatment for substance abuse: data from a multisite randomized controlled trial JO - Drug and alcohol dependence A1 - Murphy, Sean M. A1 - Campbell, Aimee N. C. A1 - Ghitza, Udi E. A1 - Kyle, Tiffany L. A1 - Bailey, Genie L. A1 - Nunes, Edward V. A1 - Polsky, Daniel SP - 119 EP - 126 VL - 161 IS - N2 - Background Substance misuse and excessive alcohol consumption are major public health issues. Internet-based interventions for substance use disorders (SUDs) are a relatively new method for addressing barriers to access and supplementing existing care. This study examines cost-effectiveness in a multisite, randomized trial of an internet-based version of the community reinforcement approach (CRA) with contingency management (CM) known as the Therapeutic Education System (TES). Methods Economic evaluation of the 12-week trial with follow-up at 24 and 36 weeks. 507 individuals who were seeking therapy for alcohol or other substance use disorders at 10 outpatient community-based treatment programs were recruited and randomized to either treatment as usual (TAU) or TES + TAU. Sub-analyses were completed on participants with a poorer prognosis (i.e., those not abstinent at study entry). Results From the provider's perspective, TES + TAU as it was implemented in this study costs $278 (SE = 87) more than TAU alone after 12 weeks. The quality-adjusted life years gained by TES + TAU and TAU were similar; however, TES + TAU has at least a 95% chance of being considered cost-effective for providers and payers with willingness-to-pay thresholds as low as $20,000 per abstinent year.

FINDINGS for the subgroup not abstinent at study entry are slightly more favorable. Conclusions With regard to the clinical outcome of abstinence, our cost-effectiveness findings of TES + TAU compare favorably to those found elsewhere in the CM literature. The analyses performed here serve as an initial economic framework for future studies integrating technology into SUD therapy.

Language: en

LA - en SN - 0376-8716 UR - http://dx.doi.org/10.1016/j.drugalcdep.2016.01.021 ID - ref1 ER -