Format
Scientific article
Publication Date
Published by / Citation
Colin Angus, Chloe Thomas, Peter Anderson, Petra S. Meier, Alan Brennan; Estimating the cost-effectiveness of brief interventions for heavy drinking in primary health care across Europe. Eur J Public Health 2017; 27 (2): 345-351. doi: 10.1093/eurpub/ckw122
Original Language

English

Keywords
ethanol
Cost-Effectiveness
alcohol
cost savings
primary health care
quality-adjusted life years
morbidity
mortality
brief intervention

Estimating the Cost-Effectiveness of Brief Interventions for Heavy Drinking in Primary Health Care across Europe

Background

Screening and brief interventions for alcohol are an effective public health measure to tackle alcohol-related harm, however relatively few countries across the European Union (EU) have implemented them widely. This may be due to a lack of understanding of the specific financial implications of such policies within each country.

Methods

A novel ‘meta-modelling’ approach was developed based on previous SBI cost-effectiveness models for four EU countries. Data were collected on the key factors which drive cost-effectiveness for all 28 EU countries (mean per capita alcohol consumption, proportion of the population to be screened over a 10-year SBI programme; per capita alcohol-attributable mortality; per capita alcohol-attributable morbidity; mean cost of an alcohol-related hospitalisation and mean SBI-delivery staff cost). Regression analysis was used to fit two metamodels estimating net programme costs and Quality-Adjusted Life Years (QALYs) gained, to calculate cost-effectiveness estimates specific to each EU country.

Results

Costs are dependent upon the proportion of the population covered by the screening programme, the country-specific per capita mortality and morbidity rate and the country-specific costs of GP care and hospitalisation. QALYs depend on the proportion of the population screened and per capita alcohol consumption. Despite large inter-country variability in factor values, SBI programmes are likely to be cost-effective in 24 out of 28 EU countries and cost-saving in 50% of countries.

Conclusion

Implementing national programmes of SBI in primary health care would be a cost-effective means of reducing alcohol-attributable morbidity and deaths in almost all countries of the EU.