Alcohol Use Disorder (AUD) remains a major public health challenge in the United States, contributing to more than 170,000 deaths each year and imposing an estimated $249 billion economic burden through healthcare costs, lost productivity and other impacts. Despite the availability of several effective medications, these treatments remain underutilized in routine clinical care.
A new study finds that medications used to treat AUD significantly reduce hospitalizations and healthcare costs, providing strong real-world evidence that pharmacologic treatment for AUD benefits both patients and the healthcare system.
Researchers from the Indiana University School of Medicine, Virginia Commonwealth University (VCU) School of Medicine and Regenstrief Institute found that patients who received medications for AUD were significantly less likely to be hospitalized for alcohol-related conditions and had lower overall medical charges than those who did not receive medication treatment.
“Alcohol Use Disorder is a leading preventable cause of liver-related morbidity, mortality and healthcare spending in the United States,” said Regenstrief and IU School of Medicine Research Scientist Wanzhu Tu, PhD., co-corresponding author of the article. “Despite strong evidence that several medications are effective in reducing alcohol use and preventing relapse, these treatments remain underutilized in routine care. Our study addresses a critical gap: whether AUD pharmacotherapy delivers measurable real-world reductions in healthcare utilization and costs.”
Closing the treatment gap
“Providers should be aware that just prescribing pharmacotherapy for AUD isn’t enough to treat AUD,” said co-first author Hanna Blaney, M.D., VCU School of Medicine. “Patients need unbiased, non-stigmatizing counseling about alcohol use, education about the benefits of pharmacotherapy, close monitoring of their response to treatment and additional behavioral support when possible.”
The researchers emphasize that medication should be part of a comprehensive treatment strategy that includes counseling, behavioral therapy and ongoing clinical monitoring.
“While these medications are generally safe to use, it’s important to remember potential drug interactions and the possibility of adverse effects,” said co-first author Chi Nguyen, IU School of Medicine.
The study examined more than 218,000 individuals with newly diagnosed AUD and compared patients who initiated pharmacotherapy within one year of diagnosis with matched patients who did not receive medication treatment. Researchers found that medication treatment was associated with:
- Lower rates of alcohol-related hospitalization
- Reduced overall alcohol-related medical charges
- Substantial reductions in inpatient care costs, which accounted for most of the savings.
Patients receiving medication also had more outpatient visits, suggesting greater engagement with ongoing care and monitoring.
Among individuals with moderate-to-severe liver disease, medication treatment was linked to nearly $27,000 lower average inpatient charges and significantly lower hospitalization risk compared with untreated patients.
Implications for health systems
“This study provides real-world, cost-effectiveness evidence supporting system-level interventions that promote pharmacological treatment for AUD,” said Dr. Tu. “Because inpatient care accounted for most cost differences, incorporating AUD pharmacotherapy into hospital-based and liver clinic pathways may meaningfully reduce avoidable admissions.”
The authors noted that patients with moderate-to-severe liver disease derive especially strong economic return per treatment dollar, though earlier treatment may help prevent disease progression and further reduce long-term healthcare costs.
The researchers say their findings provide important real-world evidence that can inform clinical guidelines, health system policies and strategies to expand access to effective treatment for alcohol use disorder.
“Real-world impact of AUD pharmacotherapy on healthcare utilization, cost, and cost-effectiveness in the U.S.,” is published in Hepatology.
This work was supported in part by NIH grants U24 AA026969 (AlcHepNet DCC to Wanzhu Tu, Samer Gawrieh, Chi M Nguyen, Yang Li, Shihui Jiang), U01 AA026917, UH3 AA026903, R01AA030312, Department of Veterans Affairs Merit Award 1I01CX000361, I01 BX006202, and Dean’s Scholar in Medical Research (to Suthat Liangpunsakul), and 1R21AA031370 (to Suthat Liangpunsakul and Jing Su), and AnalytixIN (Chi M Nguyen).
Authors
Chi M Nguyen1, Hanna L Blaney2, Jing Su1, Shihui Jiang1, Yang Li1, Yining Li1, Samer Gawrieh3, Wanzhu Tu4, Suthat Liangpunsakul5 6
Affiliations
1Department of Biostatistics & Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2Division of Gastroenterology and Hepatology, Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
3Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
4Regenstrief Institute Inc., Indianapolis, Indiana, USA.
5Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
6Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
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