IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0088041.html
   My bibliography  Save this article

Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark

Author

Listed:
  • Astrid Ledgaard Holm
  • Lennert Veerman
  • Linda Cobiac
  • Ola Ekholm
  • Finn Diderichsen

Abstract

Introduction: Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. Methods: We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs) for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. Results: Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation) were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY) per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. Conclusion: Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost-saving and should thus be first priority for implementation.

Suggested Citation

  • Astrid Ledgaard Holm & Lennert Veerman & Linda Cobiac & Ola Ekholm & Finn Diderichsen, 2014. "Cost-Effectiveness of Preventive Interventions to Reduce Alcohol Consumption in Denmark," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-9, February.
  • Handle: RePEc:plo:pone00:0088041
    DOI: 10.1371/journal.pone.0088041
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0088041
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0088041&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0088041?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jan Barendregt & Gerrit Van Oortmarssen & Ben Van Hout & Jacqueline M. Van Den Bosch & Luc Bonneux, 1998. "Coping with multiple morbidity in a life table," Mathematical Population Studies, Taylor & Francis Journals, vol. 7(1), pages 29-49.
    2. Albert Wong & Pieter H. M. van Baal & Hendriek C. Boshuizen & Johan J. Polder, 2011. "Exploring the influence of proximity to death on disease‐specific hospital expenditures: a carpaccio of red herrings," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 379-400, April.
    3. Gandjour, Afschin & Lauterbach, Karl Wilhelm, 2005. "Does prevention save costs?: Considering deferral of the expensive last year of life," Journal of Health Economics, Elsevier, vol. 24(4), pages 715-724, July.
    4. Donald S. Kenkel, 2005. "Are Alcohol Tax Hikes Fully Passed Through to Prices? Evidence from Alaska," American Economic Review, American Economic Association, vol. 95(2), pages 273-277, May.
    5. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    6. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    7. Young, Douglas J & Bieli´nska-Kwapisz, Agnieszka, 2002. "Alcohol Taxes and Beverage Prices," National Tax Journal, National Tax Association;National Tax Journal, vol. 55(1), pages 57-73, March.
    8. Luqman Tariq & Matthijs van den Berg & Rudolf T Hoogenveen & Pieter H M van Baal, 2009. "Cost-Effectiveness of an Opportunistic Screening Programme and Brief Intervention for Excessive Alcohol Use in Primary Care," PLOS ONE, Public Library of Science, vol. 4(5), pages 1-8, May.
    9. Young, Douglas J & Bieli´nska-Kwapisz, Agnieszka, 2002. "Alcohol Taxes and Beverage Prices," National Tax Journal, National Tax Association, vol. 55(N. 1), pages 57-73, March.
    10. Pieter H. M. van Baal & Talitha L. Feenstra & Johan J. Polder & Rudolf T. Hoogenveen & Werner B. F. Brouwer, 2011. "Economic evaluation and the postponement of health care costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 432-445, April.
    11. Aaron A. Stinnett & A. David Paltiel, 1997. "Estimating CE Ratios under Second-order Uncertainty," Medical Decision Making, , vol. 17(4), pages 483-489, October.
    12. Polder, Johan J. & Barendregt, Jan J. & van Oers, Hans, 2006. "Health care costs in the last year of life--The Dutch experience," Social Science & Medicine, Elsevier, vol. 63(7), pages 1720-1731, October.
    13. Anand, Sudhir & Hanson, Kara, 1997. "Disability-adjusted life years: a critical review," Journal of Health Economics, Elsevier, vol. 16(6), pages 685-702, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hill, Sarah R. & Vale, Luke & Hunter, David & Henderson, Emily & Oluboyede, Yemi, 2017. "Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges," Health Policy, Elsevier, vol. 121(12), pages 1249-1262.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Maria Gheorghe & Werner B. F. Brouwer & Pieter H. M. van Baal, 2015. "Quality of Life and Time to Death," Medical Decision Making, , vol. 35(3), pages 316-327, April.
    2. Jon P. Nelson, 2014. "Gender Differences In Alcohol Demand: A Systematic Review Of The Role Of Prices And Taxes," Health Economics, John Wiley & Sons, Ltd., vol. 23(10), pages 1260-1280, October.
    3. Padmaja Ayyagari & Partha Deb & Jason Fletcher & William Gallo & Jody L. Sindelar, 2013. "Understanding Heterogeneity In Price Elasticities In The Demand For Alcohol For Older Individuals," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 89-105, January.
    4. Nelson, Jon Paul, 2020. "Fixed-effect versus random-effects meta-analysis in economics: A study of pass-through rates for alcohol beverage excise taxes," Economics Discussion Papers 2020-1, Kiel Institute for the World Economy (IfW Kiel).
    5. Rachel Griffith & Martin O’Connell & Kate Smith, 2022. "Price Floors and Externality Correction," The Economic Journal, Royal Economic Society, vol. 132(646), pages 2273-2289.
    6. Dhaval Dave & Henry Saffer, 2007. "Risk Tolerance and Alcohol Demand Among Adults and Older Adults," NBER Working Papers 13482, National Bureau of Economic Research, Inc.
    7. Paula Carvalho Pereda & Carolina Policarpo Garcia, 2021. "Price impact of taxes on sugary drinks in Brazil," Working Papers, Department of Economics 2021_06, University of São Paulo (FEA-USP).
    8. Panayiota Lyssiotou & Elena Savva, 2021. "Who pays taxes on basic foodstuffs? Evidence from broadening the VAT base," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 28(1), pages 212-247, February.
    9. Sara Markowitz & Alison Cuellar & Ryan Conrad & Michael Grossman, 2014. "Alcohol control and foster care," Review of Economics of the Household, Springer, vol. 12(4), pages 589-612, December.
    10. Padmaja Ayyagari & Partha Deb & Jason Fletcher & William T. Gallo & Jody L. Sindelar, 2009. "Sin Taxes: Do Heterogeneous Responses Undercut Their Value?," NBER Working Papers 15124, National Bureau of Economic Research, Inc.
    11. Asatryan, Zareh & Gomtsyan, David, 2020. "The incidence of VAT evasion," ZEW Discussion Papers 20-027, ZEW - Leibniz Centre for European Economic Research.
    12. Nicoletta Berardi & Patrick Sevestre & Marine Tépaut & Alexandre Vigneron, 2016. "The impact of a ‘soda tax’ on prices: evidence from French micro data," Applied Economics, Taylor & Francis Journals, vol. 48(41), pages 3976-3994, September.
    13. Vinish Shrestha & Sara Markowitz, 2016. "The Pass-Through Of Beer Taxes To Prices: Evidence From State And Federal Tax Changes," Economic Inquiry, Western Economic Association International, vol. 54(4), pages 1946-1962, October.
    14. Jason M. Fletcher & Partha Deb & Jody L. Sindelar, 2009. "Tobacco Use, Taxation and Self Control in Adolescence," NBER Working Papers 15130, National Bureau of Economic Research, Inc.
    15. Gehrsitz, Markus & Saffer, Henry & Grossman, Michael, 2021. "The effect of changes in alcohol tax differentials on alcohol consumption," Journal of Public Economics, Elsevier, vol. 204(C).
    16. Alan Brennan & Petra Meier & Robin Purshouse & Rachid Rafia & Yang Meng & Daniel Hill-Macmanus, 2016. "Developing policy analytics for public health strategy and decisions—the Sheffield alcohol policy model framework," Annals of Operations Research, Springer, vol. 236(1), pages 149-176, January.
    17. Miravete, Eugenio J. & Seim, Katja & Thurk, Jeff, 2023. "Pass-through and tax incidence in differentiated product markets," International Journal of Industrial Organization, Elsevier, vol. 90(C).
    18. Aria Ardalan & Sebastian G. Kessing, 2021. "Tax pass-through in the European beer market," Empirical Economics, Springer, vol. 60(2), pages 919-940, February.
    19. R. Emre Aytimur, 2023. "Salience and horizontal differentiation," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 56(1), pages 60-86, February.
    20. Benjamin Bittschi & Ines Fortin & Sebastian Koch & Richard Sellner & Simon Loretz & Gregor Zwirn, 2019. "Price Elasticities and Implied Tax Revenue for Alcoholic Beverages. Evidence from Poland, France and Spain," WIFO Working Papers 579, WIFO.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0088041. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.