Acamprosate - Pharmacoeconomic implications of therapy

Acamprosate is thought to reduce the craving for alcohol. The drug helps to I maintain abstinence in alcohol-dependent patients who have successfully undergone detoxification. Abstinence rates during 3 to 12 months' treatment with acamprosate were approximately double those with placebo in most clin ical trials, although abstinence rates were generally still <50% in patient s assigned To receive acamprosate. The drug is generally well tolerated, with the most common adverse effect b eing diarrhoea. In a German cost-effectiveness model, a treatment programme including acamp rosate was the dominant strategy, producing a lifetime cost saving of 2602 Deutschmarks (1992 to 1995 values) per additional abstinent patient compare d with treatment without acamprosate. In a Belgian pharmacoeconomic model, total direct medical costs over 2 year s were 21 301 Belgian francs (1997 values) per patient lower with a treatme nt programme including acamprosate than treatment without acamprosate in al cohol-dependent patients. The main factors in the cost savings with acamprosate in these models were reduced costs for acute hospitalisation and rehabilitation/follow-up. The results of a cost-benefit analysis that considered both direct and indi rect costs for the total alcohol-dependent population in Spain were consist ently in favour of acamprosate. The lifetime net benefit for acamprosate ov er placebo (the incremental benefit) ranged between 61 642 million and 99 0 69 million pesetas (1996 values) in various scenarios with 40 to 60% of pat ients receiving treatment.