Family-Based Interventions to Prevent Substance Use Among Youth: Community Guide Systematic Economic Review

Introduction

This paper presents a systematic review of evidence from economic evaluations of family-based interventions that was recommended by the Community Preventive Services Task Force to prevent substance use among youth.

Methods

The search covered studies published from inception of databases through October 2023 and was limited to those based in the U.S. and other high-income countries. This review reports results from peer-reviewed studies and government reports as separate sources of evidence. Analyses were conducted in June 2023 through September 2024. Monetary values are in 2023 U.S. dollars.

Results

The search yielded 11 peer-reviewed studies and 2 government reports: 1 from the Washington State Institute for Public Policy that evaluated 14 programs and 1 from the Substance Abuse and Mental Health Administration that evaluated 8 programs. The median intervention cost ranged from $655 to $1,672 per family and $677 to $753 per youth or participant across the 3 sources of evidence. The median benefit to cost ratio were 5.8, 3.9, and 8.9 from peer-reviewed studies, Washington State Institute for Public Policy, and Substance Abuse and Mental Health Administration, respectively, with all 3 estimates indicating that benefits exceed cost. Substance Abuse and Mental Health Administration’s report found some interventions to be cost saving and the others to have a median cost per quality-adjusted life years gained of $21,426.

Discussion

The Community Preventive Services Task Force determined that cost–benefit evidence across the 3 sources showed that societal benefits exceeded cost of family-based interventions to prevent substance use among youth. The Task Force determined that there were not enough studies to reach a conclusion about cost-effectiveness.