The cost-effectiveness of increasing alcohol taxes: a modelling studyBMC Medicine 2008, 6:36
Excessive alcohol use increases risks of chronic diseases such as coronary heart disease and several types of cancer, with associated losses of quality of life and life-years. Alcohol taxes can be considered as a public health instrument as they are known to be able to decrease alcohol consumption.
In this paper, we estimate the cost-effectiveness of an alcohol tax increase for the entire Dutch population, from a health care perspective focusing on health benefits and health care costs in alcohol users.
To extrapolate from decreased alcohol consumption due to tax increases to effects on health care costs, life years gained and quality-adjusted life years (QALYS) gained, the RIVM Chronic Disease Model was used. A Dutch scenario in which tax increases for beer are planned, and a Swedish scenario representing one of the highest alcohol taxes in Europe, were compared to the current practice in the Netherlands. To estimate cost-effectiveness ratios, yearly differences in model outcomes between intervention and current practice scenarios were discounted and added over the time horizon of 100 years to find net present values for incremental life years gained, QALYs gained, and health care costs.
In the Swedish scenario much more QALYs were gained than in the Dutch scenario, but both scenarios have almost equal incremental cost-effectiveness ratios: E 5,100 per QALY and E 5,300 per QALY, respectively.
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