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Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT)

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7516.544 (Published 08 September 2005) Cite this as: BMJ 2005;331:544
  1. UKATT Research Team (cg2{at}york.ac.uk)
  1. Correspondence to: Christine Godfrey, professor, Department of Health Sciences, University of York, YO10 5DD

    Abstract

    Objective To compare the cost effectiveness of social behaviour and network therapy, a new treatment for alcohol problems, with that of the proved motivational enhancement therapy.

    Design Cost effectiveness analysis alongside a pragmatic randomised trial.

    Setting Seven treatment sites around Birmingham, Cardiff, and Leeds.

    Participants 742 clients with alcohol problems; 617 (83.2%) were interviewed at 12 months and full economic data were obtained on 608 (98.5% of 617).

    Main economic measures Quality adjusted life years (QALYs), costs of trial treatments, and consequences for public sector resources (health care, other alcohol treatment, social services, and criminal justice services).

    Results Both therapies saved about five times as much in expenditure on health, social, and criminal justice services as they cost. Neither net savings nor cost effectiveness differed significantly between the therapies, despite the average cost of social behaviour and network therapy (£221; $385; €320) being significantly more than that of motivational enhancement therapy (£129). If a QALY were worth £30 000, then the motivational therapy would have 58% chance of being more cost effective than the social therapy, and the social therapy would have 42% chance of being more cost effective than the motivational therapy.

    Conclusion Participants reported highly significant reductions in drinking and associated problems and costs. The novel social behaviour and network therapy did not differ significantly in cost effectiveness from the proved motivational enhancement therapy.

    Footnotes

    • Embedded ImageFull authorship details, the collaborators, and a detailed table of resources and costs are on bmj.com

    • Contributors AC was responsible for research and clinical management in the West Midlands. He contributed to the original grant application, the design, implementation, and management of the trial, analysing and interpreting data, and writing the paper. SC was responsible for designing and implementing the data management plan, and scanning, verifying, and validating data. He contributed to implementing the trial design, developing and implementing randomisation procedures, developing questionnaires and data collection instruments, analysing and interpreting data, and redrafting the paper. AF was responsible for designing and implementing the analysis plan, and validating data statistically. She contributed to implementing the trial design, developing and implementing randomisation procedures, developing data collection instruments, analysing and interpreting data, and redrafting the paper. CG was responsible for health economics. She contributed to the original grant application, the design, management, and implementation of the trial, analysing and interpreting data, and writing the paper. NH was responsible for research coordination. He contributed to the original grant application and participated in the design, implementation, and management of the trial, managing, analysing, and interpreting data, and writing the paper. RH was responsible for research and clinical management in South Wales. He contributed to the original grant application, the design, implementation and management of the trial, analysing and interpreting data, and writing the paper. VM contributed to validating, analysing, and interpreting data, and writing the paper. JO was responsible for trial coordination. He contributed to the original grant application, the design, implementation, and management of the trial, managing, analysing, and interpreting data, and writing the paper. SP was responsible for designing and implementing the health economic assessment. He contributed to implementing the trial design, developing procedures, questionnaires, and other instruments, analysing and interpreting data, and writing the paper. DR was responsible for research and clinical management in Leeds. He contributed to the original grant application, the design, implementation and management of the trial, analysing and interpreting data, and writing the paper. IR was responsible for trial methods. He contributed to the original grant application, the design, implementation, and management of the trial, managing, analysing, and interpreting data, and writing the paper. DR and IR act as guarantors. GS was responsible for designing and implementing trial management and quality assurance procedures, and coordinating the work of the treatment sites. He contributed to the implementation and management of the trial, developing procedures, questionnaires, and other instruments, designing and implementing the data management plan, verifying, validating, analysing, and interpreting data, and redrafting the paper. G Tober was responsible for therapist training and supervision. She contributed to the original grant application, the design, implementation, and management of the trial, the management and analysis of video recordings of therapy within the trial, analysing and interpreting data, and writing the paper. The local research coordinators responsible for implementing and managing the trial were: G Thistlethwaite in the integrated treatment site in Leeds; TA across four treatment sites in South Wales; and CK across two treatment sites in the West Midlands. The main follow-up interviewers were: LH and AW in Leeds; RB and BJ in South Wales; and KF and MS in the West Midlands. RB and BJ later became local research coordinators in succession to TA, and MS in succession to CK. At the trial training centre in Leeds, OF and WM analysed the video recordings of therapy. These fieldworkers also contributed to developing procedures, questionnaires, and other instruments. Together with other authors they commented on successive drafts of the paper.

    • Funding Medical Research Council, National Health Service Executive in England, and Wales Office for Research and Development in Health and Social Care.

    • Competing interests None declared.

    • Ethical approval Relevant local research ethics committees approved the trial protocol.

    • See web extra for full authorship details

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