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Research Summary

Does Naltrexone Treatment for Alcohol Disorders Reduce Health-Care Costs?

Naltrexone can decrease relapse in patients with alcohol dependence, but its effect on health-care costs is unknown. Researchers analyzed 2000–2004 data from a large health-care insurance claims database and identified 3 patient groups: a naltrexone group with an alcohol-related diagnosis and R1 claims for naltrexone (n=1138); a control group with an alcohol-related diagnosis but no claims for naltrexone (n=3411); and a control group with no alcohol-related diagnosis or claims for naltrexone (n=3410). Patients in the control groups were matched 3:1 to a naltrexone-group subject by demographics, region, health plan type, and index (start-of-naltrexone) date. Adjusted multivariable regression models were used to assess differences in health-care costs between the groups 6 months before and 6 months after the index date.

  • Compared with alcohol controls, a greater proportion of the naltrexone group had alcohol-related inpatient admissions (21% versus 1%) and outpatient office visits (50% versus 5%) in the pre-index period.
  • Mean total health-care costs increased from the pre-index to the post-index period in each group (naltrexone group, $4,829 to $5,420; alcohol controls, $2,503 to $4,576; nonalcohol controls, $1,414 to $1,496).
  • Mean alcohol-related health-care costs increased from the pre-index to the post-index period in the naltrexone group ($1,352 to $1,415; difference, +$63) and the alcohol control group ($68 to $882; difference, +$814).
  • Multivariable models showed significantly less increase pre-index to post-index in total, alcohol-related, and nonalcohol-related health-care costs in the naltrexone group compared with alcohol controls.

Comments:

These results suggest naltrexone therapy for alcohol use disorders may decrease alcohol-related and nonalcohol-related health-care costs. However, although the researchers controlled for confounders, the higher total and alcohol-related costs in the naltrexone group in the pre- and post-index period, as well as greater alcohol-treatment engagement in the pre-index period, suggest subjects in the naltrexone group may have been at a different stage of treatment engagement than alcohol controls. As a result, the greater increase in alcohol-related health-care costs for alcohol controls may have been the result of “catching-up” to the already engaged naltrexone group. Kevin L. Kraemer, MD, MSc

Reference:

Kranzler HR, Montejano LB, Stephenson JJ, et al. Effects of naltrexone treatment for alcohol-related disorders on healthcare costs in an insured population. Alcohol Clin Exp Res. 2010;34(6):1090–1097.

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