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.