Economic evaluation of interventions for problem drinking and alcohol dependence: Do within-family external effects make a difference

Duncan Mortimer, Leonie Segal

    Research output: Contribution to journalArticle

    17 Citations (Scopus)

    Abstract

    Aims: To propose methods for the inclusion of within-family external effects in clinical and economic evaluations. To demonstrate the extent of bias due to the exclusion of within-family external effects when measuring the relative performance of interventions for problem drinking and alcohol dependence. Methods: The timing and magnitude of treatment effects are modified to accommodate the external health-related quality of life impact of having a problem or dependent drinker in the family home. Results: The inclusion of within-family external effects reduces cost per QALY estimates of interventions for problem drinking and alcohol dependence thereby improving the performance of all evaluated interventions. In addition, the inclusion of within-family external effects improves the relative performance of interventions targeted at those with moderate-to-severe alcohol dependence as compared to interventions targeted at less severe alcohol problems. Conclusions: Failure to take account of external effects in clinical and economic evaluations results in an uneven playing field. Interventions with readily quantifiable health benefits (where social costs and benefits are predominantly comprised of private costs and benefits) are at a distinct advantage when competing for public funding against interventions with quantitatively important external effects.

    Original languageEnglish
    Pages (from-to)92-98
    Number of pages7
    JournalAlcohol and Alcoholism
    Volume41
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2006

    ASJC Scopus subject areas

    • Medicine (miscellaneous)
    • Toxicology
    • Psychiatry and Mental health

    Cite this