Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia.
OBJECTIVE
To evaluate cost-effectiveness of eight interventions for reducing alcohol-attributable harm and determine the optimal intervention mix.


METHODS
Interventions include volumetric taxation, advertising bans, an increase in minimum legal drinking age, licensing controls on operating hours, brief intervention (with and without general practitioner telemarketing and support), drink driving campaigns, random breath testing and residential treatment for alcohol dependence (with and without naltrexone). Cost-effectiveness is modelled over the life-time of the Australian population in 2003, with all costs and health outcomes evaluated from an Australian health sector perspective. Each intervention is compared with current practice, and the most cost-effective options are then combined to determine the optimal intervention mix.


METHODS
Cost-effectiveness is measured in 2003 Australian dollars per disability adjusted life year averted.


RESULTS
Although current alcohol intervention in Australia (random breath testing) is cost-effective, if the current spending of $71 million could be invested in a more cost-effective combination of interventions, more than 10 times the amount of health gain could be achieved. Taken as a package of interventions, all seven preventive interventions would be a cost-effective investment that could lead to substantial improvement in population health; only residential treatment is not cost-effective.


CONCLUSIONS
Based on current evidence, interventions to reduce harm from alcohol are highly recommended. The potential reduction in costs of treating alcohol-related diseases and injuries mean that substantial improvements in population health can be achieved at a relatively low cost to the health sector.
School of Population Health, The University of Queensland, Queensland, Australia. l.cobiac@uq.edu.au
Linda
L
Cobiac
Theo
T
Vos
Christopher
C
Doran
Angela
A
Wallace
D000293:Adolescent; D000328:Adult; D000329:Advertising / Q000191:economics; D000428:Alcohol Drinking / Q000453:epidemiology / Q000331:legislation & jurisprudence / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D001315:Australia; D001334:Automobile Driving; D001944:Breath Tests; D002648:Child; D003132:Commerce / Q000331:legislation & jurisprudence; D003362:Cost-Benefit Analysis; D015276:Health Care Rationing; D006801:Humans; D008004:Licensure / Q000191:economics; D015993:Life Tables; D011314:Preventive Health Services / Q000191:economics* / Q000458:organization & administration; D011614:Psychotherapy, Brief / Q000191:economics; D015813:Substance Abuse Detection / Q000191:economics; D013660:Taxes / Q000191:economics*; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult