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Applied Health Economics and Health Policy
Erschienen in: Applied Health Economics and Health Policy 4/2016

01.08.2016 | Original Research Article

A Trial-Based Predictive Microsimulation Assessing the Public Health Benefits of Nalmefene and Psychosocial Support for the Reduction of Alcohol Consumption in Alcohol Dependence

verfasst von: Philippe Laramée, Aurélie Millier, Nora Rahhali, Olivier Cristeau, Samuel Aballéa, Clément François, Ylana Chalem, Mondher Toumi, Jürgen Rehm

Erschienen in: Applied Health Economics and Health Policy | Ausgabe 4/2016

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Abstract

Background

Alcohol dependence causes considerable harm to patients. Treatment with nalmefene, aiming to reduce consumption rather than maintain complete abstinence, has been licensed based on trials demonstrating a reduction in total alcohol consumption and heavy drinking days. Relating these trial outcomes to harmful events avoided is important to demonstrate the clinical relevance of nalmefene treatment.

Methods

A predictive microsimulation model was developed to compare nalmefene plus brief psychosocial intervention (BRENDA) versus placebo plus BRENDA for the treatment of patients with alcohol dependence and a high or very high drinking risk level based on three pooled clinical trials. The model simulated patterns and level of alcohol consumption, day-by-day, for 12 months, to estimate the occurrence of alcohol-attributable diseases, injuries and deaths; assessing the clinical relevance of reducing alcohol consumption with treatment.

Results

The microsimulation model predicted that, in a cohort of 100,000 patients, 971 (95 % confidence interval [CI] 904–1038) alcohol-attributable diseases and injuries and 133 (95 % CI 117–150) deaths would be avoided with nalmefene versus placebo. This level of benefit has been considered clinically relevant by the European Medicines Agency.

Conclusions

This microsimulation model supports the clinical relevance of the reduction in alcohol consumption, and has estimated the extent of the public health benefit of treatment with nalmefene in patients with alcohol dependence and a high or very high drinking risk level.
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Fußnoten
1
BRENDA therapy consists of six components: Biopsychosocial evaluation, Report to the patient on assessment, Empathic understanding of the patient’s situation, Needs collaboratively identified by the patients and treatment provider, Direct advice to the patient on how to meet those needs, and Assess reaction of the patient to advice and adjust as necessary for best care [16].
 
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Metadaten
Titel
A Trial-Based Predictive Microsimulation Assessing the Public Health Benefits of Nalmefene and Psychosocial Support for the Reduction of Alcohol Consumption in Alcohol Dependence
verfasst von
Philippe Laramée
Aurélie Millier
Nora Rahhali
Olivier Cristeau
Samuel Aballéa
Clément François
Ylana Chalem
Mondher Toumi
Jürgen Rehm
Publikationsdatum
01.08.2016
Verlag
Springer International Publishing
Erschienen in
Applied Health Economics and Health Policy / Ausgabe 4/2016
Print ISSN: 1175-5652
Elektronische ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-016-0248-z

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