The health and economic consequences of moderate alcohol consumption in Germany 2002.
OBJECTIVE
Moderate alcohol consumption is associated with both positive and negative health effects. This study aims to estimate the positive and negative consequences on mortality, years of potential life (YPL), quality-adjusted life-years (QALYs), resource utilization, and societal costs attributable to moderate alcohol consumption in Germany in 2002.


METHODS
The concept of attributable risks and a prevalence-based approach was used to calculate age- and sex-specific alcohol attributable mortality and resource utilization for a wide range of disorders, and avoided mortality and resource utilization for diabetes mellitus, coronary heart disease, stroke, and cholelithiasis. The literature provided prevalence of moderate alcohol consumption in Germany by age and sex and relative risks. Direct costs were calculated using routine utilization and expenditure statistics. Indirect costs were calculated using the human capital approach.


RESULTS
Due to moderate alcohol consumption, 14,457 lives, 205,691 YPL, and 179,964 QALYs were lost, whereas 29,918 lives, 300,382 YPL, and 258,284 QALYs were gained. Up to an age of 55 to 60 (62.5-67.5) years, more lives were lost than gained among men (women), whereas in older age groups more lives were gained than lost. Moderate alcohol consumption caused euro3049 million of direct and euro2630 million of indirect costs, whereas euro2094 million of direct and euro2604 million of indirect costs were avoided.


CONCLUSIONS
Despite considerable uncertainty, moderate alcohol consumption seems to result in an overall net effect of gained lives, YPL, and QALYs, realized among the elderly, but overall increased societal costs. Thus, moderate alcohol consumption should still be seen critical, especially among youths.
Konnopka
Alexander
A
University of Leipzig, Health Economics Research Unit, Department of Psychiatry, Leipzig, Germany. alexander.konnopka@medizin.uni-leipzig.de
König
Hans-Helmut
HH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000191:economics* / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009017:Morbidity; D015995:Prevalence; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012306:Risk; D018570:Risk Assessment; D055815:Young Adult