Home > Are the “best buys” for alcohol control still valid? An update on the comparative cost-effectiveness of alcohol control strategies at the global level.

Chisholm, Ian and Moro, Daniela and Bertram, Melanie and Pretorius, Carel and Gmel, Gerrit . (2018) Are the “best buys” for alcohol control still valid? An update on the comparative cost-effectiveness of alcohol control strategies at the global level. Rutgers. Journal of Studies on Alcohol and Drugs, 79 (4) 514–22.

URL: https://www.jsad.com/doi/10.15288/jsad.2018.79.514

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.


Item Type:Evidence resource
Publication Type:Review
Drug Type:Alcohol
Intervention Type:AOD disorder, AOD disorder harm reduction
Date:2018
Pages:514–22
Publisher:Rutgers
Volume:79
Number:4
EndNote:View
Subjects:A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
B Substances > Alcohol
L Social psychology and related concepts > Economic availability or accessibility
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use > Harm reduction policy
MP-MR Policy, planning, economics, work and social services > Economic policy
MP-MR Policy, planning, economics, work and social services > Economic aspects of substance use (cost / pricing)
VA Geographic area > International aspects

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