Background
A systematic review of the literature was undertaken to examine the impact of minimum unit pricing (MUP) on alcohol-related hospitalisations.1 The review also sought to determine if MUP had an effect on length of hospital stay for alcohol-related conditions, on hospital mortality, and for alcohol-related liver disease. Given that the costs of alcohol-related hospitalisations on the Irish healthcare system are estimated at €1.5 billion (in 2012) and the high levels of alcohol use in Ireland, legislation to reduce alcohol use and related harms were introduced in 2018.2–4 A component of this legislation, the Public Health (Alcohol) Act 2018, is MUP, set at €1.00 per standard drink or per 10 g of alcohol. Ireland is one of the few countries globally to introduce such a measure, as well as certain provinces in Canada; Northern Territory, Australia; Scotland; Wales; Jersey; Armenia; Belarus; Kyrgyzstan; Moldova; Russia; Ukraine; and Uzbekistan.5

Methods
A systematic search of MEDLINE, Embase, Scopus, APA PsycInfo, CINAHL Plus, and Cochrane Reviews as well as a search of grey literature was carried out between 1 January and 11 November 2022. Inclusion criteria were studies evaluating the impact of MUP with no restriction on country of origin.

Results
Along with 20 studies retrieved from grey literature, 591 articles were identified from the search, with the final number meeting the inclusion criteria at 22: five from Canada, six from England, three from Scotland, two from Wales, one from Northern Ireland, one from Ireland, three from Australia, and one from South Africa. Almost three-quarters of the studies used modelling studies (n=16), most commonly the Sheffield Alcohol Policy Model.6 There were six natural experiments studies: two originated from Canada, one from Scotland, and three from Australia.

Modelling studies
The results from the modelling studies are displayed in Table 1.

Table 1: Findings from modelling studies, by country

MUP: minimum unit pricing; ALD: alcoholic liver disease; UK: United Kingdom.

Table 2 presents summarised findings from the natural experiments.

Table 2: Findings from natural experiments studies, by country

MUP: minimum unit pricing; ALD: alcoholic liver disease; ICU: intensive care unit.

­Discussion
The findings from this systematic review support policies that include MUP to reduce alcohol-related hospitalisations. Furthermore, such policy implementation impact is most effective in tackling health inequalities. The review included studies that compared the effectiveness of MUP with general alcohol taxation, bans on below-cost sales, and restrictions on price promotions. The authors note that MUP cannot be considered a ‘panacea to all alcohol-related issues’ (p. 9) and is most effective when combined with other alcohol control measures.1

1    Maharaj T, Angus C, Fitzgerald N, et al. (2023) Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review. BMJ Open, 13: e065220. Available from: https://www.drugsandalcohol.ie/38116/

2    Mongan D and Long J (2016) Alcohol in Ireland: consumption, harm, cost and policy response. HRB Overview Series 10. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/25697/

3    Mongan D, Millar SR and Galvin B (2021) The 2019–20 Irish National Drug and Alcohol Survey: main findings. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/34287/

4    Office of the Attorney General (2018) Public ­Health (Alcohol) Act 2018. Dublin: Irish Statute Book. Available from: https://www.drugsandalcohol.ie/33698/

5    Neufeld M, Bobrova A, Davletov K, et al. (2021) Alcohol control policies in Former Soviet Union countries: a narrative review of three decades of policy changes and their apparent effects. Drug Alcohol Rev, 40: 350–367.

6    Angus C, Gillespie D, Ally A, et al. (2015) Modelling the impact of minimum unit price and identification and brief advice policies using the Sheffield Alcohol Policy Model version 3. Sheffield: University of Sheffield.