Direct and indirect costs attributable to alcohol consumption in Germany.
OBJECTIVE
To estimate the direct and indirect costs of morbidity and mortality attributable to alcohol consumption in Germany from a societal perspective in 2002.


METHODS
Using the concept of attributable risks and the prevalence-based approach, age- and gender-specific alcohol-attributable fractions for morbidity and mortality were calculated for alcoholic disorder, neoplasms, endocrinological, nervous, circulatory, digestive, skin and perinatal disorders, and injuries and poisonings. The literature provided data on alcohol consumption in Germany by age, gender and dose amount, and relative risks. Direct costs were calculated based on routine resource utilisation and expenditure statistics. Indirect costs were calculated based on the human capital approach using a discount rate of 5%.


RESULTS
Alcohol consumption accounted for 5.5% of all deaths and 970,000 years of potential life lost. Total costs were euro24,398 million, amounting to 1.16% of Germany's GDP, or euro296 per person. Direct medical and non-medical costs were euro8441 million. Indirect costs were euro15,957 million (69% mortality and 31% morbidity costs). In contrast, protective health effects of alcohol consumption saved euro4839 million.


CONCLUSIONS
The magnitude of alcohol-attributable morbidity and mortality and associated costs demands more preventive efforts.
Konnopka
Alexander
A
Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Johannisallee 20, Leipzig, Germany. alexander.konnopka@medizin.uni-leipzig.de
König
Hans-Helmut
HH
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000191:economics* / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000191:economics* / Q000401:mortality; D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation; D017281:Cost of Illness; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence