Mo. Howard, ASSESSING THE COMPARATIVE COST-EFFECTIVENESS OF ALCOHOLISM TREATMENTS- A COMMENT ON HOLDER, LONGABAUGH, MILLER AND RUBONIS, Journal of studies on alcohol, 54(6), 1993, pp. 667-675
Holder, Longabaugh, Miller and Rubonis (JSA, vol. 53, pp. 517-540, 199
1) discuss the shortcomings of the empirical literature relevant to an
assessment of the comparative cost-effectiveness of alcoholism treatm
ent modalities. Their analysis is rooted in an attempt to conjoin the
literatures pertaining to clinical efficacy and costs of alcohol depen
dence treatment. Holder et al.'s methodology is flawed in a number of
respects and they exceed the bounds of the evidence when they endorse
particular treatment modalities as comparatively cost-effective. Gener
alizations as to the relative cost-effectiveness of particular modalit
ies are forwarded despite the fact that treatments are applied to pers
ons with alcohol problems of widely varying severity. Additional point
s of contention are raised regarding the authors' selection of accepta
ble studies and interpretation of findings. Despite these limitations,
Holder et al.'s (1991) analysis is a seminal heuristic contribution t
o the discussion of cost-effectiveness in the alcoholism field.