title: The cost-effectiveness of increasing alcohol taxes: a modelling study.
abstract: BACKGROUND
  Excessive alcohol use increases risks of chronic diseases such as coronary heart disease and several types of cancer, with associated losses of quality of life and life-years. Alcohol taxes can be considered as a public health instrument as they are known to be able to decrease alcohol consumption. In this paper, we estimate the cost-effectiveness of an alcohol tax increase for the entire Dutch population from a health-care perspective focusing on health benefits and health-care costs in alcohol users.
  
  
  METHODS
  The chronic disease model of the National Institute for Public Health and the Environment was used to extrapolate from decreased alcohol consumption due to tax increases to effects on health-care costs, life-years gained and quality-adjusted life-years gained, A Dutch scenario in which tax increases for beer are planned, and a Swedish scenario representing one of the highest alcohol taxes in Europe, were compared with current practice in the Netherlands. To estimate cost-effectiveness ratios, yearly differences in model outcomes between intervention and current practice scenarios were discounted and added over the time horizon of 100 years to find net present values for incremental life-years gained, quality-adjusted life-years gained, and health-care costs.
  
  
  RESULTS
  In the Swedish scenario, many more quality-adjusted life-years were gained than in the Dutch scenario, but both scenarios had almost equal incremental cost-effectiveness ratios: 5100 euros per quality-adjusted life-year and 5300 euros per quality-adjusted life-year, respectively.
  
  
  CONCLUSIONS
  Focusing on health-care costs and health consequences for drinkers, an alcohol tax increase is a cost-effective policy instrument.
authors.affiliation: Centre for Public Health Forecasting, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. matthijs.van.den.berg@rivm.nl
authors.forename: Matthijs
authors.initials: M
authors.lastname: van den Berg
authors.forename: Pieter Hm
authors.initials: PH
authors.lastname: van Baal
authors.forename: Luqman
authors.initials: L
authors.lastname: Tariq
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Schuit
authors.forename: G Ardine
authors.initials: GA
authors.lastname: de Wit
authors.forename: Rudolf T
authors.initials: RT
authors.lastname: Hoogenveen
mesh_terms: D000428:Alcohol Drinking / Q000191:economics* / Q000453:epidemiology; D000437:Alcoholism / Q000191:economics* / Q000453:epidemiology; D003198:Computer Simulation / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006291:Health Policy / Q000191:economics; D006801:Humans; D009426:Netherlands; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013660:Taxes / Q000191:economics* / Q000639:trends; D013997:Time Factors