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CDT test cuts care costs for chronically ill patients


A health economics analysis found that adding a new alcohol biomarker test to patients' revelations about their drinking habits could lower the cost of caring for patients with chronic illnesses like diabetes and high blood pressure.

The alcohol-screening test measures the level of a chemical in the blood -- carbohydrate deficient transferrin -- which is responsive to alcohol. A cost-benefit analysis by Michael Fleming, and colleagues found that the CDT test increases the number of problem drinkers detected in a population of primary care patients.

The benefit-cost model -- which uses data from surveys, published literature and two trials -- is published in the journal Alcoholism: Clinical and Experimental Research. The analysis estimates that CDT testing results in $212.30 in overall savings per patient by avoiding some medical and legal costs.

The alcohol biomarker is approved by the U.S. Food and Drug Administration ( FDA ), but Fleming said that many primary care physicians do not know about the CDT technology.

CDT is not a test for alcoholism; it can't judge whether a patient is dependent on alcohol, Fleming said. But the test can detect if a patient has consumed four to five alcoholic drinks a day within the last two weeks.

Once harmful drinking is identified through a CDT test, Fleming said a physician can try to rein in a patient's heavy alcohol consumption.

Heavy drinking can worsen illnesses like high blood pressure, diabetes and heart disease. Excessive alcohol consumption can also interfere with medications commonly prescribed for those conditions.

Peter Miller, a researcher at the Center for Drug and Alcohol Programs at the Medical University of South Carolina, is working to encourage more physicians to consider CDT in their care of patients who have alcohol-sensitive illnesses.

Miller said the CDT test is especially helpful when a patient has received proper treatment and made lifestyle changes, but his or her condition is still not under control. A patient who is taking three medicines for hypertension might be able to control the condition with one drug, Miller said, after a CDT test confirms excessive alcohol consumption and the patient cuts back on alcohol use.

Cost savings came mainly from decreases in hospitalization, fewer accidents and trauma incidents as well as a reduction in emergency room visits, Fleming said. Those economic benefits are realized within about four years after the test, the analysis estimates.

Source: Center for the Advancement of Health, 2005


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