Dan Chisholm1,2,3, Daniela Moro4, Melanie Bertram5, Carel Pretorius6, Gerrit Gmel7, Kevin Shield7,8,9, Jürgen Rehm7,3. 1. Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. 2. Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada. 3. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 4. University of Cagliari, Sardinia, Italy. 5. Department of Health Governance and Financing, World Health Organization, Geneva, Switzerland. 6. Avenir Health, Glastonbury, Connecticut. 7. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada. 8. PAHO/WHO Collaborating Centre for Mental Health and Addiction, CAMH, Toronto, Ontario, Canada. 9. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: Evidence on the comparative cost-effectiveness of alcohol control strategies is a relevant input into public policy and resource allocation. At the global level, this evidence has been used to identify so-called best buys for noncommunicable disease prevention and control. This article uses global evidence on alcohol use exposures and risk relations, as well as on intervention costs and impacts, to re-examine the comparative cost-effectiveness of a range of alcohol control strategies. METHOD: A "generalized" approach to cost-effectiveness analysis was adopted. A new modeling tool (OneHealth) was used to estimate the population-level effects of interventions. Interventions that reduce the harmful use of alcohol included brief psychosocial interventions, excise taxes, and the enactment as well as enforcement of restrictions on alcohol marketing, availability, and drink-driving laws. Costs were estimated in international dollars for the year 2010 and effects expressed in healthy life years gained. Analysis was carried out for 16 countries spanning low-, middle-, and high-income settings. RESULTS: Increasing excise taxes has a low cost (<I$0.10 per capita) and a highly favorable ratio of costs to effects (<I$100 per healthy life year gained in both low- and high-income settings). Availability and marketing restrictions are also highly cost effective (<I$100 in low-income settings and <I$500 in high-income settings). Enforcement of drink-driving laws and blood alcohol concentration limits via sobriety checkpoints had cost-effectiveness ratios in the range of I$1,500-3,000. Brief psychosocial treatments were <I$150 and <I$1,500 in low- and high-income settings, respectively. CONCLUSIONS: More than a decade after an initial global analysis, the findings of this study indicate pricing policies and restrictions to alcohol availability and marketing continue to represent a highly cost-effective use of resources.
OBJECTIVE: Evidence on the comparative cost-effectiveness of alcohol control strategies is a relevant input into public policy and resource allocation. At the global level, this evidence has been used to identify so-called best buys for noncommunicable disease prevention and control. This article uses global evidence on alcohol use exposures and risk relations, as well as on intervention costs and impacts, to re-examine the comparative cost-effectiveness of a range of alcohol control strategies. METHOD: A "generalized" approach to cost-effectiveness analysis was adopted. A new modeling tool (OneHealth) was used to estimate the population-level effects of interventions. Interventions that reduce the harmful use of alcohol included brief psychosocial interventions, excise taxes, and the enactment as well as enforcement of restrictions on alcohol marketing, availability, and drink-driving laws. Costs were estimated in international dollars for the year 2010 and effects expressed in healthy life years gained. Analysis was carried out for 16 countries spanning low-, middle-, and high-income settings. RESULTS: Increasing excise taxes has a low cost (<I$0.10 per capita) and a highly favorable ratio of costs to effects (<I$100 per healthy life year gained in both low- and high-income settings). Availability and marketing restrictions are also highly cost effective (<I$100 in low-income settings and <I$500 in high-income settings). Enforcement of drink-driving laws and blood alcohol concentration limits via sobriety checkpoints had cost-effectiveness ratios in the range of I$1,500-3,000. Brief psychosocial treatments were <I$150 and <I$1,500 in low- and high-income settings, respectively. CONCLUSIONS: More than a decade after an initial global analysis, the findings of this study indicate pricing policies and restrictions to alcohol availability and marketing continue to represent a highly cost-effective use of resources.
Authors: Pol Rovira; Carolin Kilian; Maria Neufeld; Harriet Rumgay; Isabelle Soerjomataram; Carina Ferreira-Borges; Kevin D Shield; Bundit Sornpaisarn; Jürgen Rehm Journal: Eur Addict Res Date: 2020-12-03 Impact factor: 3.015
Authors: Bronwyn Myers; Tara Carney; Jennifer Rooney; Samantha Malatesta; Laura F White; Charles D H Parry; Tara C Bouton; Elizabeth J Ragan; Charles Robert Horsburgh; Robin M Warren; Karen R Jacobson Journal: Int J Environ Res Public Health Date: 2021-05-19 Impact factor: 3.390
Authors: Maria Neufeld; Jürgen Rehm; Anna Bunova; Artyom Gil; Boris Gornyi; Pol Rovira; Jakob Manthey; Elena Yurasova; Svetlana Dolgova; Bulat Idrisov; Marina Moskvicheva; Galina Nabiullina; Olga Shegaym; Irina Zhidkova; Zukhra Ziganshina; Carina Ferreira-Borges Journal: Bull World Health Organ Date: 2021-03-19 Impact factor: 9.408
Authors: Jürgen Rehm; Mindaugas Štelemėkas; Carina Ferreira-Borges; Huan Jiang; Shannon Lange; Maria Neufeld; Robin Room; Sally Casswell; Alexander Tran; Jakob Manthey Journal: Int J Environ Res Public Health Date: 2021-03-02 Impact factor: 3.390