The costs of hazardous alcohol consumption in Germany

Hazardous alcohol consumption in Germany is a main threat to health. By using insurance claim data from the German Statutory Health Insurance and a classification strategy based on ICD10 diagnoses-codes we analyzed a sample of 146,000 subjects with more than 19,000 hazardous alcohol consumers. Employing different regression models with a control function approach, we calculate life years lost due to alcohol consumption, annual direct and indirect health costs, and the burden of pain and suffering measured by the Charlson-Index and assessed pain diagnoses. Additionally, we simulate the net accumulated premium payments over expenses in the German Statutory Health Insurance and the Statutory Pension Fund for hazardous alcohol consumers from a lifecycle perspective. In total, €39.3 billion each year result from hazardous alcohol consumption with an average loss of 7 years in life expectancy. Hazardous alcohol consumers clearly do not "pay their way" in the two main German social security systems and also display a higher intangible burden according to our definitions of pain and suffering.     

The mortality, morbidity, and economic costs of alcohol abuse in New Hampshire

Since alcoholism and alcohol abuse are the number one health problem in the United States, community-based estimates of mortality, morbidity, and economic costs associated with alcohol abuse are needed to convey their impact in local areas. In the state of New Hampshire, data were collected on alcohol consumption patterns, alcohol-associated mortality, years of potential life lost, hospital days associated with alcohol-related diagnoses, direct medical care costs, employment levels, and per capita incomes. Alcohol-attributable mortality and morbidity percentages were applied to these data to estimate the effects of alcohol abuse. In 1983, alcohol was associated with 4% of total statewide deaths. These included 37% of the deaths due to injury, 26% of the deaths due to digestive disease, and 3% of the deaths due to cancer. These deaths represented over 6,000 years of potential life lost. Between 4 and 7% of hospital days were attributable to alcohol-related diagnoses. Direct medical care costs attributable to alcohol were over $101 million; 10% of the direct medical costs in the state. Indirect costs (present value of lost earnings due to premature mortality and morbidity associated with alcohol) represented over $142 million. Property damage and insurance costs associated with alcohol were almost $13 million, and alcohol-related arrests added another $17 million. Excess absenteeism due to alcohol abuse cost another $33 million and lost productivity at work cost over $278 million. These economic costs totaled almost $600 million, or 5% of the gross state product. The methodology used to obtain these results is easily applied and is shown in the Appendix.     

The social and economic costs of alcohol abuse in Minnesota, 1983.

Alcohol abuse in the State of Minnesota has an impact on health, health care resources, and the economy. Alcohol abuse was related to 3.3 per cent (1,150) of deaths in Minnesota in 1983; of these, almost one-third were the result of fatal injuries. Alcohol abuse contributed to 12 per cent (33,909) of all years of potential life lost, two-thirds of which were secondary to injury. The estimated cost of alcohol abuse ranged from $1.4 billion to $2.1 billion, representing from 2.8 per cent to 4.3 per cent of all personal income of Minnesotans, from 32 per cent to 50 per cent of State expenditures, and from 26 to 39 times the alcohol excise tax revenues generated in 1983. Alcohol-related direct medical care costs were estimated to be at least $216 million, 3.8 per cent of Minnesota medical costs for 1983. Costs of reduced on-the-job productivity and short-term absenteeism related to alcohol abuse were estimated to be between $630 million and $1.2 billion. The documentation of the costs of alcohol abuse is an important step in the campaign to reduce alcohol-related deaths, morbidity, and health care costs.     

The economic impact of alcohol consumption: a systematic review

Background  

Many opiate users entering British prisons require prescribed medication to help them achieve abstinence. This commonly takes the form of a detoxification regime. Previously, a range of detoxification agents have been prescribed without a clear evidence base to recommend a drug of choice. There are few trials and very few in the prison setting. This study compares dihydrocodeine with buprenorphine.     

The economic impact of alcohol consumption: a systematic review

Background  

Information on the economic impact of alcohol consumption can provide important evidence in supporting policies to reduce its associated harm. To date, several studies on the economic costs of alcohol consumption have been conducted worldwide. This study aims to review the economic impact of alcohol worldwide, summarizing the state of knowledge with regard to two elements: (1) cost components included in the estimation; (2) the methodologies employed in works conducted to date.     

Optimum alcohol taxation: Balancing consumption and external costs

This paper considers alternative approaches to the evaluation of the total cost of alcohol consumption in Australia. It calculates the impact of alternative tax rates on beer, wine and spirits separately and the ‘consumption cost’ of these taxes in terms of the distortion caused to consumption patterns. Two separate analyses are carried out. First optimal taxation is calculated which minimises the total loss from the ‘consumption cost’ of taxation plus the external cost of alcohol consumption. Secondly, the benefits of life are separated from other benefits and the impact of tax expressed in terms of the cost per life year gained. Conceptualised in this way, the results of this ‘tax’ program may be expressed in the same way as other health programs, namely as a net cost per life year gained. Alcohol taxation may then be compared with other life saving interventions. The chief conclusion reached is that in Australia there is a very compelling case for a new tax base and for a very significant increase in the rate of alcohol taxation.     

Melioidosis in animals, Thailand, 2006-2010

We retrospectively estimated the incidence of culture-proven melioidosis in animals in Thailand during 2006-2010. The highest incidence was in goats (1.63/100,000/year), followed by incidence in pigs and cattle. The estimated incidence of melioidosis in humans in a given region paralleled that of melioidosis in goats.     

Estimates of economic costs of alcohol and drug abuse and mental illness, 1985 and 1988

The high prevalence of alcohol and drug abuse and mental illness imposes a substantial financial burden on those affected and on society. The authors present estimates of the economic costs from these causes for 1985 and 1988, based on current and reliable data available from national surveys and the use of new costing methodology. The total losses to the economy related to alcohol and drug abuse and mental illness for 1988 are estimated at $273.3 billion. The estimate includes $85.8 billion for alcohol abuse, $58.3 billion for drug abuse, and $129.3 billion for mental illness. The total estimated costs for 1985, $218.1 billion, include $51.4 billion for direct treatment and support costs; $80.8 billion for morbidity costs, the value of reduced or lost productivity; $35.8 billion for mortality costs, the value of foregone future productivity for the 140,593 premature deaths associated with these disorders, based on a 6 percent discount rate and including an imputed value for housekeeping services; and $47.5 billion in other related costs, including the costs of crime, motor vehicle crashes, fire destruction, and the value of productivity losses for victims of crime, incarceration, crime careers, and caregiver services. The cost of acquired immunodeficiency syndrome associated with drug abuse is estimated at $1 billion, and the cost of fetal alcohol syndrome is estimated at $1.6 billion. The estimates may be considered lower limits of the true costs to society of alcohol and drug abuse and mental illness in the United States.     

The economic costs of illicit drug use in Ontario, 1992

The use of illicit drugs causes health and social problems which imply economic costs to society. This paper uses the cost-of-illness method, in particular, the human–capital approach to estimate the prevalence-based economic costs of illicit drug use in Ontario in 1992. This methodology is consistent with international guidelines formulated at the 1994 International Symposium on Economic and Social Costs of Substance Abuse. The economic cost of illicit drug use is estimated at $489.29 million (Canadian dollars) in 1992. Associated with these costs are health-related harms: 211 deaths, half of which occur before the age of 35; and 20 690 days stay in public hospitals. © 1998 John Wiley & Sons, Ltd.     

The economic costs of Alzheimer's disease.

This paper estimates the economic costs of Alzheimer's Disease to individuals and to society, based on review of published Alzheimer's Disease-related research. The analysis is derived from epidemiological projections and cost information for the United States population in 1983. Estimated costs include both direct medical care and social support costs, as well as indirect costs, such as support services provided by family or volunteers, and the value of lost economic productivity in Alzheimer's Disease patients. Mid-range estimates of net annual expected costs for an Alzheimer's Disease patient, excluding the value of lost productivity, are $18,517 in the first year and $17,643 in subsequent years, with direct medical and social services comprising about half of these costs. Under base case assumptions, the total cost of disease per patient in 1983, was $48,544 to $493,277, depending upon patient's age at disease onset. The estimated present value of total net costs to society for all persons first diagnosed with Alzheimer's Disease in 1983 was $27.9-31.2 billion. Development of a public or private insurance market for the economic burdens of Alzheimer's Disease would fill some of the gaps in the current US system of financing long-term chronic disease care.     

The economic costs of the health effects of smoking, 1984

The impact of cigarette smoking on morbidity and mortality in the United States is well known. Economic consequences of these health effects--expenditures for medical care and the value of productive output lost--have been estimated in many ways. This original prevalence-based analysis of attributable risks indicates a staggering $54 billion cost to the nation. Concern over such misallocation of resources to harmful uses is demonstrably justified.     

The morbidity,mortality, and economic costs of cigarette smoking in New Hampshire

The Surgeon General of the United States Public Health Service has identified cigarette smoking as the single most important source of preventable morbidity and premature mortality. An analysis was conducted in the state of New Hampshire to determine the consequences of smoking: morbidity, mortality, and economic costs to the population. Data were collected on smoking prevalence, smoking attributed deaths, years of potential life lost, hospital days attributed to smoking diagnoses, direct medical costs, and per capita incomes. Smoking attributable fractions were applied to these data. In 1983, 16% of total statewide deaths were attributable to cigarette smoking. These deaths included 15% of the cardiovascular deaths, 20% of cancer deaths, 42% of respiratory disease deaths, 3% of digestive disease deaths, and 5% of infant deaths, in a population of less than 1 million. These deaths represented almost 3100 years of potential life lost. Smoking attributable hospital days totaled almost 70,000, for 8% of male and 4% of female hospital days. Direct medical care costs attributable to cigarette smoking were over $76 million, 7% of the total statewide medical costs. Indirect costs (present value of lost earnings due to premature mortality and morbidity attributable to smoking) were almost $118 million. These economic costs totaled almost $200 million. The results of this study were used extensively by the New Hampshire media and volunteer agencies. This methodology can be a model for other local area analyses.Robin D. Gorsky, Ph.D. is an Assistant Professor in the Department of Health Management and Policy, University of New Hampshire, Durham, NH 03824. Eugene Schwartz, M.D., M.P.H. is Epidemiologist and Director of the Bureau of Cancer Control, Washington, DC. David Dennis, M.D., M.P.H., is the Director of the Bureau of Disease Control, Commonwealth of Pennsylvania, and in the Division of Field Services, Epidemiology Program Office, Centers for Disease Control, Atlanta, GA. This study was completed at and supported in part by the Bureau of Disease Control, Division of Public Health Services, Department of Health and Human Services, Concord, NH, and the Department of Health Management and Policy, University of New Hampshire, Durham, NH. Requests for reprints should be addressed to: Robin D. Gorsky, Ph.D., Department of Health Management and Policy, University of New Hampshire, Durham, NH 03824.