Health Systems Research Seminar: The Cost Effectiveness of Strategies to Prevent and Treat Alcohol Abuse
Wednesday, November 29, 2017, 10:00 a.m. to 12:00 p.m.
Greg Zaric, PhD
Professor, Management Science
Ivey Business School
Alcohol consumption is a costly public health problem, associated with an increased risk of disability and mortality. Prevention and treatment can include counseling, psychosocial support, and some pharmacologic interventions.
We developed a microsimulation model to estimate the cost-effectiveness of interventions to prevent and treat alcohol abuse. The model simulates a cohort of 100,000,000 people from age 17 to age 110 in 1-year time steps. In each time step individuals are classified as being in one of three drinking states (lifetime abstainer, current drinker or former drinker) or two treatment states (psychosocial treatment only or psychosocial treatment plus pharmacologic treatment). Among current drinkers, changes in annual consumption are based on age, sex, and current drinking status. Transition rates were estimated using three large databases, and treatment efficacy was modeled based on clinical trial results.
We used the model to evaluate the cost effectiveness of two interventions. First, we evaluated the cost effectiveness of routine screening for alcohol abuse as part of an annual physician visit. We found this to be cost effective with an incremental cost effectiveness ratio (ICER) of less than $15,000/QALY gained for men and women. Second, we evaluated the cost effectiveness of nalmefene treatment in combination with psychosocial support compared to psychosocial support alone in an alcohol dependent population with high or very high drinking risk levels. Nalmefene is an opioid antagonist that is believed to reduce the analgesic and positive reward effect of alcohol and therefore has the potential to reduce alcohol consumption. Nalmefene has been approved for use in Europe but it is not available in North America. We found that nalmefene was not likely to be cost effective if use was restricted to one year.
In ongoing work we are developing a web-based interface for the model so that policy makers in other jurisdictions can adjust parameters and obtain analyses that are relevant to their situation.
- Wednesday, November 29, 2017
- 10:00 a.m. to 12:00 p.m.
- Telfer School of Management
55 Laurier Avenue East
Ottawa, Ontario K1N 6N5
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About the Speaker
Greg Zaric is a Professor of Management Science at the Ivey Business School, University of Western Ontario. He is also cross appointed in the departments of Statistical and Actuarial Sciences and Epidemiology and Biostatistics. His research focuses on using mathematical and economic models to analyze problems in health policy, health economics and healthcare operations management. His work has been funded by NSERC, CIHR, MITACS, and the Canadian Centre for Applied Research in Cancer Control, and he previously held the Canada Research Chair in Health Care Management Science. He serves on the editorial boards of Operations Research, Production and Operations Management, Healthcare Management Science, and several other journals. He holds a PhD from Stanford, and MAsc from the University of Waterloo, and a BSc from Western University.