The Swedish state health technology board (SBU) report on treatment of alcohol and drug misuse: An economist's view

Abstract

The Swedish State Health Technology Board (SBU) has published a Report on the treatment of alcohol and drug misuse (SBU, 2001). This article is a brief Commentary on the economic issues raised in Chapter 9 of the Report, in particular, the question of 'how cost-effective are the different treatment alternatives?' An outline is given of how the authors approached the economic work, with particular reference to a standard checklist approach to judging the quality of published economic appraisals. A paucity of such appraisals was retrieved and detailed review of just 16 papers was undertaken. The authors are critical of the lack of quality of economic work in the substance misuse area and their main points are summarized here. The main conclusion drawn is that no economic judgements can be made about alternative treatment approaches, and more study and research are needed in this area. Chapter 9 is, on balance, a good attempt at a critical review of the economic appraisal literature. Unfortunately the main Report provides a series of summary judgements on the effectiveness or otherwise of alternative treatments, which, while recognizing the need for further cost-effectiveness work, essentially ignores the conclusion drawn in the economics chapter. This is likely to do a disservice to the cause of appropriate resource allocation in the substance misuse area.