title: Modelling lifetime QALYs and health care costs from different drinking patterns over time: a Markov model.
abstract: The negative health consequences of alcohol use and its treatment account for significant health care expenditure worldwide. Long-term modelling techniques are developed in this paper to establish a link between drinking patterns, health consequences and alcohol treatment effectiveness and cost-effectiveness. The overall change in health related quality and quantity of life which results from changes in health-related behaviour is estimated. Specifically, a probabilistic lifetime Markov model is presented where alcohol consumption in grams of alcohol per day and drinking history are used for the categorization of patients into four Markov states. Utility weights are assigned to each drinking state using EQ-5D scores. Mortality and morbidity estimates are state, gender and age specific, and are alcohol-related and non-alcohol-related. The methodology is tested in a case study. This represents a major development in the techniques traditionally used in alcohol economic models, in which short-term costs and outcomes are assessed, omitting potential longer term cost savings and improvements in health related quality of life. Assumptions and implications of the approach are discussed.
authors.affiliation: Centre for Health Economics and Department of Health Sciences, University of York, York, UK. cppb500@york.ac.uk
authors.forename: Carolina
authors.initials: C
authors.lastname: Barbosa
authors.forename: Benjamin
authors.initials: B
authors.lastname: Taylor
authors.forename: Christine
authors.initials: C
authors.lastname: Godfrey
authors.forename: Juergen
authors.initials: J
authors.lastname: Rehm
authors.forename: Steve
authors.initials: S
authors.lastname: Parrott
authors.forename: Colin
authors.initials: C
authors.lastname: Drummond
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000188:drug therapy / Q000191:economics / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000191:economics; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D004326:Drinking / Q000502:physiology*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011336:Probability; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult