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Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark

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  • Astrid Ledgaard Holm
  • Lennert Veerman
  • Linda Cobiac
  • Ola Ekholm
  • Finn Diderichsen

Abstract

Introduction: Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. Methods: We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs) for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. Results: Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation) were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY) per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. Conclusion: Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost-saving and should thus be first priority for implementation.

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  • Astrid Ledgaard Holm & Lennert Veerman & Linda Cobiac & Ola Ekholm & Finn Diderichsen, 2014. "Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.
  • Handle: RePEc:plo:pone00:0088041
    DOI: 10.1371/journal.pone.0088041
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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Jan Barendregt & Gerrit Van Oortmarssen & Ben Van Hout & Jacqueline M. Van Den Bosch & Luc Bonneux, 1998. "Coping with multiple morbidity in a life table," Mathematical Population Studies, Taylor & Francis Journals, vol. 7(1), pages 29-49.
    3. Young, Douglas J & Bieli´nska-Kwapisz, Agnieszka, 2002. "Alcohol Taxes and Beverage Prices," National Tax Journal, National Tax Association;National Tax Journal, vol. 55(1), pages 57-73, March.
    4. Luqman Tariq & Matthijs van den Berg & Rudolf T Hoogenveen & Pieter H M van Baal, 2009. "Cost-Effectiveness of an Opportunistic Screening Programme and Brief Intervention for Excessive Alcohol Use in Primary Care," PLOS ONE, Public Library of Science, vol. 4(5), pages 1-8, May.
    5. Young, Douglas J & Bieli´nska-Kwapisz, Agnieszka, 2002. "Alcohol Taxes and Beverage Prices," National Tax Journal, National Tax Association, vol. 55(N. 1), pages 57-73, March.
    6. Albert Wong & Pieter H. M. van Baal & Hendriek C. Boshuizen & Johan J. Polder, 2011. "Exploring the influence of proximity to death on disease‐specific hospital expenditures: a carpaccio of red herrings," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 379-400, April.
    7. Pieter H. M. van Baal & Talitha L. Feenstra & Johan J. Polder & Rudolf T. Hoogenveen & Werner B. F. Brouwer, 2011. "Economic evaluation and the postponement of health care costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 432-445, April.
    8. Gandjour, Afschin & Lauterbach, Karl Wilhelm, 2005. "Does prevention save costs?: Considering deferral of the expensive last year of life," Journal of Health Economics, Elsevier, vol. 24(4), pages 715-724, July.
    9. Aaron A. Stinnett & A. David Paltiel, 1997. "Estimating CE Ratios under Second-order Uncertainty," Medical Decision Making, , vol. 17(4), pages 483-489, October.
    10. Donald S. Kenkel, 2005. "Are Alcohol Tax Hikes Fully Passed Through to Prices? Evidence from Alaska," American Economic Review, American Economic Association, vol. 95(2), pages 273-277, May.
    11. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    12. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    13. Anand, Sudhir & Hanson, Kara, 1997. "Disability-adjusted life years: a critical review," Journal of Health Economics, Elsevier, vol. 16(6), pages 685-702, December.
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    Cited by:

    1. Hill, Sarah R. & Vale, Luke & Hunter, David & Henderson, Emily & Oluboyede, Yemi, 2017. "Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges," Health Policy, Elsevier, vol. 121(12), pages 1249-1262.

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