Analytical approach:
This economic evaluation was based on an algebraic model with a lifetime horizon. The authors stated that the perspectives of society and the health care system were adopted.
Effectiveness data:
The clinical data were derived from a systematic literature review which included mainly randomised controlled trials (RCTs). The search was carried out in the PubMed database. A number of well-defined inclusion criteria were reported to ensure the comparability of the studies in terms of type of intervention and outcomes used. Average values were calculated to combine the clinical estimates from multiple studies. Some assumptions were also made to select the most appropriate estimate from those available. The key clinical endpoint was the effectiveness of counselling in changing alcohol consumption.
Monetary benefit and utility valuations:
The utility valuations were derived from published studies, using a methodology that was extensively described in an appendix. The instruments used to elicit patient preferences were not reported.
Measure of benefit:
Quality-adjusted life-years (QALYs) were the summary benefit measure. A 3% annual discount rate was applied.
Cost data:
The economic analysis included the costs of screening, history taking, brief counselling (which included both patient and physician time), and alcohol attributable disease and injuries (including alcohol-related crimes, motor vehicle crashes, fire destruction, and social welfare administration, but not transfer payments of social welfare). The value of time was based on Medicare reimbursement rates for physicians and average earnings for patients. Other costs were derived from a published study. All costs were in US dollars ($) and the price year was 2000. They were discounted at an annual rate of 3%.
Analysis of uncertainty:
A deterministic one- and multi-way sensitivity analysis was undertaken to examine the impact of all the model inputs using ranges of values based on published sources or authors’ judgement.