Cost effectiveness of brief interventions for reducing alcohol consumption.
The direct costs and health effects of a primary-care-based brief intervention for hazardous alcohol consumption were examined. The total cost of the intervention was calculated from costs associated with: marketing the intervention programme; providing training and support in the use of the intervention materials; physician time required for providing brief advice for 'at-risk' drinkers. The effect of the intervention on health outcomes was expressed in terms of number of life years saved by preventing alcohol-related deaths. This was derived by combining estimates of the impact of the programme if it were implemented nationally with available evidence on the health effects of excess alcohol consumption. Results are based on international trial evidence showing the physical resources required by the intervention and its effectiveness combined with Australian price data. The costs associated with screening and brief advice using the current intervention programme range from Aus$19.14 to Aus$21.50. The marginal costs per additional life year saved were below Aus$1873. The robustness of the model used is supported by an extensive sensitivity analysis. In comparison with existing health promotion strategies the costs and effects of the current intervention are highly encouraging.
Department of Psychological Medicine, University of Sydney, Australia. swutzke@med.usyd.edu.au
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Wutzke
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Shiell
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Gomel
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Conigrave
D000428:Alcohol Drinking / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D001315:Australia / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics; D005260:Female; D006266:Health Education / Q000191:economics; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D011635:Public Health Administration; D026712:Value of Life