Cost-effectiveness of an opportunistic screening programme and brief intervention for excessive alcohol use in primary care.
BACKGROUND
Effective prevention of excessive alcohol use has the potential to reduce the public burden of disease considerably. We investigated the cost-effectiveness of Screening and Brief Intervention (SBI) for excessive alcohol use in primary care in the Netherlands, which is targeted at early detection and treatment of 'at-risk' drinkers.


RESULTS
We compared a SBI scenario (opportunistic screening and brief intervention for 'at-risk' drinkers) in general practices with the current practice scenario (no SBI) in The Netherlands. We used the RIVM Chronic Disease Model (CDM) to extrapolate from decreased alcohol consumption to effects on health care costs and Quality Adjusted Life Years (QALYs) gained. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. In total, 56,000 QALYs were gained at an additional cost of 298,000,000 euros due to providing alcohol SBI in the target population, resulting in a cost-effectiveness ratio of 5,400 euros per QALY gained.


CONCLUSIONS
Prevention of excessive alcohol use by implementing SBI for excessive alcohol use in primary care settings appears to be cost-effective.
Tariq
Luqman
L
Centre for Prevention and Health Services Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. luqman.tariq@rivm.nl
van den Berg
Matthijs
M
Hoogenveen
Rudolf T
RT
van Baal
Pieter H M
PH
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000191:economics* / Q000517:prevention & control*; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D019057:Quality-Adjusted Life Years