| Alcohol dependence treatments: comprehensive healthcare costs, utilization outcomes, and pharmacotherapy persistence. | |
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MedLine Citation:
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PMID: 21761948 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: To determine the healthcare costs associated with treatment of alcohol dependence with medications versus no medication and across the 4 medications approved by the US Food and Drug Administration (FDA). STUDY DESIGN: Retrospective claims database analysis. METHODS: Eligible adults with alcohol dependence were identified from a large US health plan and the IMS PharMetrics Integrated Database. Data included all medical and pharmacy claims at all available healthcare sites. Propensity score-based matching and inverse probability weighting were applied to baseline demographic, clinical, and healthcare utilization variables for 20,752 patients, half of whom used an FDA-approved medication for alcohol dependence. A similar comparison was performed among 15,502 patients treated with an FDA-approved medication: oral acamprosate calcium (n = 8958), oral disulfiram (n = 3492), oral naltrexone (NTX) hydrochloride (n = 2391), or extended-release injectable naltrexone (XR-NTX; n = 661). Analyses calculated 6-month treatment persistence, utilization, and paid claims for: alcoholism medications, detoxification and rehabilitation, alcohol-related and nonrelated inpatient admissions, outpatient services, and total costs.RESLUTS: Medication was associated with fewer admissions of all types. Despite higher costs for medications, total healthcare costs, including inpatient, outpatient, and pharmacy costs, were 30% lower for patients who received a medication for their alcohol dependence. XR-NTX was associated with greater refill persistence and fewer hospitalizations for any reason and lower hospital costs than any of the oral medications. Despite higher costs for XR-NTX itself, total healthcare costs were not significantly different from oral NTX or disulfiram, and were 34% lower than with acamprosate. CONCLUSION: In this largest cost study to date of alcohol pharmacotherapy, patients who received medication had lower healthcare utilization and total costs than patients who did not. XR-NTX showed an advantage over oral medications in treatment persistence and healthcare utilization, at comparable or lower total cost. |
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Authors:
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Onur Baser; Mady Chalk; Richard Rawson; David R Gastfriend |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of managed care Volume: 17 ISSN: 1936-2692 ISO Abbreviation: Am J Manag Care Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-07-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: S222-34 Citation Subset: H |
Affiliation:
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852 Winter St, Waltham, MA 02139.E-mail: david.gastfriend@alkermes.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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