Cost-Effectiveness of Nalmefene Added to Psychosocial Support for the Reduction of Alcohol Consumption in Alcohol-Dependent Patients With High/Very High Drinking Risk Levels: A Microsimulation Model

Cost-Effectiveness of Nalmefene Added to Psychosocial Support for the Reduction of Alcohol Consumption in Alcohol-Dependent Patients With High/Very High Drinking Risk Levels: A Microsimulation Model

2017 J Stud Alcohol Drugs

Millier, A. | Laramee, P. | Rahhali, N. | Aballea, S. | Daeppen, J. B. | Rehm, J. | Toumi, M. | Volume: 78, Issue: 6, Pages: 867-876, Alcohol Drinking/economics/*prevention & control, Alcoholism/*therapy, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Naltrexone/administration & dosage/*analogs & derivatives, *Quality-Adjusted Life Years, Risk,

OBJECTIVE: A microsimulation model was adapted to evaluate the cost-effectiveness of nalmefene combined with psychosocial support (NMF + PS) versus psychosocial support alone (PS). The economic impact of alcohol reduction using nalmefene treatment was not evaluated. METHOD: The model simulates patient-level alcohol consumption over a 5-year time horizon across different treatment cohorts. Study outcomes included probabilities of alcohol-attributable diseases and injuries as well as deaths from these events. The approach used nalmefene clinical trial data, a time horizon of 1 and 5 years, and a U.K. societal perspective. Extensive deterministic and probabilistic sensitivity analyses were conducted. RESULTS: Compared with the PS strategy, NMF + PS was associated at Year 5 with a gain of 0.047 quality-adjusted life years (QALYs) and an additional pound503, leading to an incremental cost-effectiveness ratio (ICER) of pound10,613 per QALY gained. When compared with the strategy without treatment, NMF + PS was associated with a gain of 0.228 QALYs and an additional pound1,795, leading to an ICER of pound1,758 per QALY gained. The NMF + PS strategy dominated both treatment strategies when considering the U.K. societal perspective. Sensitivity analyses confirmed the robustness of the results. CONCLUSIONS: A combination of NMF and PS was better than PS alone, considering a 5-year time horizon and a societal perspective.

https://www.doi.org/10.15288/jsad.2017.78.867