background A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction.
aim To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers.
method We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (qaly). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs.
results The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (icer), remaining below the threshold of € 20,000 per qaly. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the icer was less than € 20,000 per qaly.
conclusion Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.