title: The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse: evidence from rural Australia.
abstract: OBJECTIVE
  This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice.
  
  
  METHODS
  A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia.
  
  
  RESULTS
  Based on evidence from current practice, approximately 19% of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7% would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100%, 36% of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10% and 20% in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1% and 4.2% respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197.
  
  
  CONCLUSIONS
  These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Building R3, 22-32 King Street, Randwick Campus, Sydney, NSW 2031, Australia. h.navarro@unsw.edu.a
authors.forename: Héctor José
authors.initials: HJ
authors.lastname: Navarro
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Doran
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Petrie
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics*; D005194:Family Practice / Q000379:methods; D005260:Female; D058005:General Practitioners; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D008962:Models, Theoretical; D009517:New South Wales; D012309:Risk-Taking; D012423:Rural Health; D055815:Young Adult