An economic analysis of Native CHOICES

Introduction: Fetal alcohol spectrum disorders (FASDs) are a costly collection of conditions caused by alcohol exposed pregnancies (AEPs). Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) is an evidence-based CDC program for AEP prevention. Native CHOICES is a cultural adaptation of CHOICES shown to be effective for reducing AEP risk in American Indian communities. The current study represents the first economic analysis of Native CHOICES. Methods: Using pre-pandemic data from a randomized controlled trial of Native CHOICES in a Northern Plains American Indian community, the cost-benefit, cost effectiveness, and quality of adjusted life years (QALY) were assessed for Native CHOICES. Results: Native CHOICES lowered AEP risk by 18–20 % during the 6 months following program participation, thus lowering FASDs by an estimated 6.84–7.6 %. Economic analysis of Native CHOICES' impact on lowered AEP and FASD risk revealed Native CHOICES' net economic benefit of $308,295 to $376,951 for the 6 months following the program, with cost efficiency ratios for FASDs avoided ranging from $84,887 to $93,709, and $2330 to $2572 per quality adjusted life years gained. Conclusion: Economic analysis results indicate that Native CHOICES is a cost-effective program for AEP and FASD prevention among American Indian participants in the intervention.