{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:16:21Z","timestamp":1768565781311,"version":"3.49.0"},"posted":{"date-parts":[[2024,8,23]]},"group-title":"Addiction Medicine","reference-count":52,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,8,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Alcohol use disorder (AUD) is a major public health concern and cause of mortality and morbidity. Alcohol-associated liver disease (ALD) is a debilitating complication of AUD, mitigated by abstinence from alcohol use. Deep brain stimulation (DBS) is emerging as a potential treatment for AUD. However, its cost-effectiveness compared to the standard medical treatment is unclear.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate the cost-effectiveness of DBS compared to medical management for patients with AUD and ALD.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We utilized a decision analytic model based on published literature to conduct a cost-effectiveness analysis of costs and health outcomes for DBS and medical management in patients with AUD and ALD. We also carried out a threshold analysis to determine the probability of success necessary for DBS to be cost-effective. Costs were measured in 2024 US dollars and effectiveness in quality-adjusted life years (QALYs). We used a time horizon of 1-2 years and adopted a societal perspective.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our results show that for AUD patients in general, DBS is not cost-effective at any DBS success rate. However, for advanced ALD patients, defined as fibrosis stage 3 or beyond DBS becomes cost-effective. For these patients, DBS is cost-effective over a two-year period at a $100,000 willingness-to-pay threshold at DBS success rates greater than 53%. For advanced decompensated ALD patients, DBS is cost-effective over a one-year period at DBS success rate greater than 35%.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Should it prove efficacious, DBS may be cost-effective for patients with AUD and ALD. Thus, future randomized controlled trials to evaluate its efficacy are warranted.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.08.22.24312455","type":"posted-content","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T22:10:12Z","timestamp":1724451012000},"source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness Analysis of Deep Brain Stimulation for the Treatment of Alcohol Use Disorder and Alcoholic Liver Disease"],"prefix":"10.64898","author":[{"given":"O.A.","family":"Abiola","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6378-0428","authenticated-orcid":false,"given":"K.","family":"Moussawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Jalal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2024082712350548000_2024.08.22.24312455v1.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-0997-0"},{"key":"2024082712350548000_2024.08.22.24312455v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.05.031"},{"key":"2024082712350548000_2024.08.22.24312455v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70099-2"},{"key":"2024082712350548000_2024.08.22.24312455v1.4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.579"},{"key":"2024082712350548000_2024.08.22.24312455v1.5","unstructured":"Prevention, C.f.D.C.a. Annual Average for United States 2011\u20132015 Alcohol-Attributable Deaths Due to Excessive Alcohol Use, All Ages. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI) 2020 December 8, 2020]; Available from: https:\/\/nccd.cdc.gov\/DPH_ARDI\/Default\/Default.aspx."},{"issue":"1","key":"2024082712350548000_2024.08.22.24312455v1.6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/s41572-018-0014-7","article-title":"Alcoholic liver disease","volume":"4","year":"2018","journal-title":"Nature Reviews Disease Primers"},{"issue":"3","key":"2024082712350548000_2024.08.22.24312455v1.7","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1001\/jama.2021.10626","article-title":"Alcohol-Related Diseases Increased as Some People Drank More During the COVID-19 Pandemic","volume":"326","year":"2021","journal-title":"JAMA"},{"issue":"7","key":"2024082712350548000_2024.08.22.24312455v1.8","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1002\/hep4.1706","article-title":"COVID-19 Aftershocks on Alcohol-Associated Liver Disease: An Early Cross-Sectional Report From the U","volume":"5","year":"2021","journal-title":"S. 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