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

Holm, Astrid Ledgaard, Veerman, Lennert, Cobiac, Linda, Ekholm, Ola and Diderichsen, Finn (2014) Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark. PLoS One, 9 2: e88041.1-e88041.9. doi:10.1371/journal.pone.0088041


Author Holm, Astrid Ledgaard
Veerman, Lennert
Cobiac, Linda
Ekholm, Ola
Diderichsen, Finn
Title Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2014-02-01
Year available 2014
Sub-type Article (original research)
DOI 10.1371/journal.pone.0088041
Open Access Status DOI
Volume 9
Issue 2
Start page e88041.1
End page e88041.9
Total pages 9
Place of publication San Francisco, CA United States
Publisher Public Library of Science
Language eng
Formatted 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. 
Keyword Routine General Practice
Ischemic Heart Disease
Global Burden
Heavy Drinkers
Primary care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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