Trial reportArchives of general psychiatry2008
Cost and cost-effectiveness of the COMBINE study in alcohol-dependent patients.
Trial report in Archives of general psychiatry, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Economic evaluations of alcohol pharmacotherapy: Systematic review of economic evaluations of pharmacotherapy for the treatment of alcohol use disorder.The Australian and New Zealand journal of psychiatry · 2024Pooled it
- Systematic Review of Combined Pharmacotherapy for the Treatment of Alcohol Use Disorder in Patients Without Comorbid Conditions.CNS drugs · 2018Pooled it
- Cost and cost-effectiveness of abstinence-contingent wage supplements for adults experiencing homelessness and alcohol use disorder.Journal of substance use and addiction treatment · 2025Trial
- Reconsidering alcohol treatment non-responders: psychosocial functioning among heavy drinkers 3 years following treatment.Addiction (Abingdon, England) · 2021Trial
- Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder.Journal of general internal medicine · 2021Trial
- Trial
- Interim methadone and patient navigation in jail: Rationale and design of a randomized clinical trial.Contemporary clinical trials · 2016Trial
- Motivational tools to improve probationer treatment outcomes.Contemporary clinical trials · 2015Trial
- Cost-effectiveness of the strong African American families-teen program: 1-year follow-up.Drug and alcohol dependence · 2013Trial
- Cost-effectiveness analysis of motivational interviewing with feedback to reduce drinking among a sample of college students.Journal of studies on alcohol and drugs · 2012Trial
- Cost-effectiveness of peer-delivered interventions for cocaine and alcohol abuse among women: a randomized controlled trial.PloS one · 2012Trial
- Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment.Journal of psychoactive drugsTrial
- Development and evaluation of objective trial performance metrics for multisite clinical studies: Experience from the AlcHep Network.Contemporary clinical trials · 2024Article
- Modeling the impact of a long-term horizon and multiple treatment episodes on estimates of the cost-effectiveness of alcohol treatment in the United States.Alcohol, clinical & experimental research · 2023Article
- Systems analysis and improvement approach to improve naloxone distribution within syringe service programs: study protocol of a randomized controlled trial.Implementation science : IS · 2023Article
- Constructs derived from the addiction cycle predict alcohol use disorder treatment outcomes and recovery 3 years following treatment.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2023Article
- The Use of Anticonvulsant Adjuncts to Treat Alcohol Withdrawal Syndrome in Older Adults.Canadian geriatrics journal : CGJ · 2022Article
- Within-AUD outpatient treatment heavy drinking transitions and associations with long-term outcomes.Drug and alcohol dependence · 2021Article
- Cost-effectiveness of alcohol use treatments in patients with alcohol-related cirrhosis.Journal of hepatology · 2021Article
- Patterns of transitions between relapse to and remission from heavy drinking over the first year after outpatient alcohol treatment and their relation to long-term outcomes.Journal of consulting and clinical psychology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
contextThe COMBINE (Combined Pharmacotherapies and Behavioral Intervention) clinical trial recently evaluated the efficacy of medications, behavioral therapies, and their combinations for the outpatient treatment of alcohol dependence. The costs and cost-effectiveness of these combinations are unknown and of interest to clinicians and policy makers.
objectiveTo evaluate the costs and cost-effectiveness of the COMBINE Study interventions after 16 weeks of treatment.
designA prospective cost and cost-effectiveness study of a randomized controlled clinical trial.
settingEleven US clinical sites.
participantsOne thousand three hundred eighty-three patients having a diagnosis of primary alcohol dependence.
interventionsThe study included 9 treatment groups; 4 groups received medical management for 16 weeks with naltrexone, 100 mg/d, acamprosate, 3 g/d, or both, and/or placebo; 4 groups received the same therapy as mentioned earlier with combined behavioral intervention; and 1 group received combined behavioral intervention only. MAIN OUTCOMES MEASURES: Incremental cost per percentage point increase in percentage of days abstinent, incremental cost per patient of avoiding heavy drinking, and incremental cost per patient of achieving a good clinical outcome.
resultsOn the basis of the mean values of cost and effectiveness, 3 interventions are cost-effective options relative to the other interventions for all 3 outcomes: medical management (MM) with placebo ($409 per patient), MM plus naltrexone therapy ($671 per patient), and MM plus combined naltrexone and acamprosate therapy ($1003 per patient).
conclusionsTo our knowledge, this is only the second prospective cost-effectiveness study with a randomized controlled clinical trial design that has been performed for the treatment of alcohol dependence. Focusing only on effectiveness, MM-naltrexone-acamprosate therapy is not significantly better than MM-naltrexone therapy. However, considering cost and cost-effectiveness, MM-naltrexone-acamprosate therapy may be a better choice, depending on whether the cost of the incremental increase in effectiveness is justified by the decision maker.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.