Modelling the cost-effectiveness of alcohol screening and brief interventions in primary care in England

Purshouse, R. C., Brennan, A., Rafia, R., Latimer, N. R., Archer, R. J., Angus, C. R., Preston, L. R. and Meier, P. S. (2013) Modelling the cost-effectiveness of alcohol screening and brief interventions in primary care in England. Alcohol and Alcoholism, 48(2), pp. 180-188. (doi: 10.1093/alcalc/ags103) (PMID:23015608)

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Abstract

Aims: To estimate the cost-effectiveness and resourcing implications of universal alcohol screening and brief intervention (SBI) programmes in primary care in England. Methods: This was a health economic model, combining evidence of the effectiveness and health care resource requirements of SBI activities with existing epidemiological modelling of the relationship between alcohol consumption and health harms. Results: Screening patients on registration with a family doctor would steadily capture ∼40% of the population over a 10-year programme; screening patients at next primary care consultation would capture 96% of the population over the same period, but with high resourcing needs in the first year. The registration approach, delivered by a practice nurse, provides modest cost savings to the health care system of £120 m over 30 years. Health gains over the same period amount to 32,000 quality-adjusted life years (QALYs). This SBI programme still appears cost-effective (at £6900 per QALY gained) compared with no programme, under pessimistic effectiveness assumptions. Switching to a consultation approach, delivered by a doctor, would incur an incremental net cost of £108 m, with incremental health gains equivalent to 92,000 QALYs, giving an incremental cost-effectiveness ratio of £1175 per QALY gained compared with current practice. Conclusion: A universal programme of alcohol SBI in primary care is estimated to be cost-effective, under all but the most pessimistic assumptions for programme costs and effectiveness. Policymakers should ensure that SBI programmes are routinely evaluated and followed up, given the substantial uncertainty over the effects of many of the implementation details.

Item Type:Articles
Additional Information:This review was funded by the National Institute for Health and Clinical Excellence (NICE) for the purpose of informing public health guidance (grant number R/120080). The interpretation, analysis and views expressed are those of the authors and not necessarily those of NICE.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Meier, Professor Petra
Authors: Purshouse, R. C., Brennan, A., Rafia, R., Latimer, N. R., Archer, R. J., Angus, C. R., Preston, L. R., and Meier, P. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Alcohol and Alcoholism
Publisher:Oxford University Press
ISSN:0735-0414
ISSN (Online):1464-3502
Published Online:25 September 2012

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