The online version of this article (doi:10.1186/1471-2296-15-26) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
CA performed the modelling and drafted the article. ES and SG provided data and expertise on population baseline characteristics. AT and FF provided data and expertise on hospital admissions and costs. PS provided data and expertise on primary care. ES, SG, AT, FF and PS provided expertise on the Italian context and healthcare system. RP and AB provided modelling expertise and guidance. All authors read and approved the final manuscript.
As alcohol-related health problems continue to rise, the attention of policy-makers is increasingly turning to Screening and Brief Intervention (SBI) programmes. The effectiveness of such programmes in primary healthcare is well evidenced, but very few cost-effectiveness analyses have been conducted and none which specifically consider the Italian context.
The Sheffield Alcohol Policy Model has been used to model the cost-effectiveness of government pricing and public health policies in several countries including England. This study adapts the model using Italian data to evaluate a programme of screening and brief interventions in Italy. Results are reported as Incremental Cost-Effectiveness Ratios (ICERs) of SBI programmes versus a ‘do-nothing’ scenario.
Model results show such programmes to be highly cost-effective, with estimated ICERs of €550/Quality Adjusted Life Year (QALY) gained for a programme of SBI at next GP registration and €590/QALY for SBI at next GP consultation. A range of sensitivity analyses suggest these results are robust under all but the most pessimistic assumptions.
This study provides strong support for the promotion of a policy of screening and brief interventions throughout Italy, although policy makers should be aware of the resource implications of different implementation options.
Ministero della Salute: Legge Quadro In Materia Di Alcol e Problemi alcolcorrelati. Relazione Del Ministro Della Salute Al Parlamento Sugli Interventi Realizzati Aisensi Della Legge. 2003, Rome, Italy: Ministero della Salute
World Health Organization (Geneva): European Action Plan to Reduce the Harmful use of Alcohol 2012–2020. 2012, Copenhagen, Denmark: World Health Organisation Regional Office for Europe
Salute M d: Piano Nazionale Alcol E Salute. 2007, Roma
Kaner EFS, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, Heather N, Saunders J, Burnand B: Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev Online. 2007, 4: CD004148
Jackson R, Johnson M, Campbell F, Messina J, Guillaume L, Meier P, Goyder E, Chillcott J, Payne N: Screening and Brief Interventions for Prevention and Early Identification of Alcohol Use Disorders in Adults and Young People. 2009, Sheffield: University of Sheffield, School of Health and Related Research (ScHARR) Public Health Collaborating Centre
Elzerbi C, Donoghue K, Drummond C: Report on the European Public Health Impact and Cost Effectiveness of Early Diagnosis and Treatment of Alcohol Use Disorders. 2013
Latimer N, Guillaume L, Goyder E: Prevention and Early Identification of Alcohol Use Disorders in Adults and Young People: Screening and Brief Interventions: Cost Effectiveness Review. 2008, Sheffield
Schmidt C, Schulte B, Donnell AO, Newbury-birch D, Degwitz P, Verthein U: Effectiveness of Brief Interventions in Primary Health Care, Emergency Care. 2013, Hamburg: Workplace Health Services and Social Services
Meng Y, Hill-McManus D, Brennan A, Meier P: Model-Based Appraisal of Alcohol Minimum Pricing and Off-Licensed Trade Discount Bans in Scotland Using the Sheffield Alcohol Policy Model (v.2): Second Update Based on Newly Available Data. 2012, Sheffield: University of Sheffield, School of Health and Related Research (ScHARR)
Purshouse R, Brennan A, Latimer N, Meng Y, Rafia R, Jackson R, Meier P: Modelling to Assess the Effectiveness and Cost-Effectiveness of Public Health Related Strategies and Interventions to Reduce Alcohol Attributable Harm in England Using the Sheffield Alcohol Policy Model Version 2.0. 2009, Sheffield: Publisher: University of Sheffield, School of Health and Related Research (ScHARR) Public Health Collaborating Centre
Gunning-Schepers L: The health benefits of prevention: a simulation approach. Health Policy (New York). 1989, 12: 1-255.
Capri S, Ceci A, Terranova L: Guidelines for economic evaluations in Italy: recommendations from the Italian group of pharmacoeconomic studies. Drug Inf J. 2001, 35: 189-201.
ISTAT: Indagine Multiscopo Sulle Famiglie - Aspetti Della Vita Quotidiana. 2008, Rome, Italy: Istituto Nazionale di Statistica
Scafato E, Ghirini S, Galluzzo L, Farchi G: Epidemiologia e Monitoraggio Alcol-Correlato in Italia. Valutazione dell’Osservatorio Nazionale Alcol-CNESPS Sull'impatto Dell'uso e Abuso Di Alcol Ai Fini Dell'implementazione Dell Attivita Del Piano Nazionale Alcol e Salute. 2009, Roma: Istituto Superiore di Sanità
Ezzati M, Lopez A, Rodgers A, Murray JL: Comparative Quantification of Health Risks: Global and Regional Burden of Diseases Attributable to Selected Major Risk Factors. 2004, Geneva: World Health Organisation
Dutch Hospital Data: LMR Database for Hospital Admissions. 2010, Utrecht, Netherlands: Dutch Hospital Data
Tramacere I, Negri E, Bagnardi V, Garavello W, Rota M, Scotti L, Islami F, Corrao G, Boffetta P, La Vecchia C: A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 1: overall results and dose-risk relation. Oral Oncol. 2010, 46: 497-503. 10.1016/j.oraloncology.2010.03.024. CrossRefPubMed
Corrao G, Bagnardi V, Zambon A, La Vecchia C: A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med (Baltim). 2004, 38: 613-619. CrossRef
Islami F, Tramacere I, Rota M, Bagnardi V, Fedirko V, Scotti L, Garavello W, Jenab M, Corrao G, Straif K, Negri E, Boffetta P, La Vecchia C: Alcohol drinking and laryngeal cancer: overall and dose-risk relation–a systematic review and meta-analysis. Oral Oncol. 2010, 46: 802-810. 10.1016/j.oraloncology.2010.07.015. CrossRefPubMed
Brennan A, Purshouse R, Taylor K, Rafia R, Booth A, O’Reilly D, Stockwell T, Sutton A, Wilkinson A, Wong R: Independent Review of the Effects of Alcohol Pricing and Promotion. Part B: Modelling the Potential Impact of Pricing and Promotion Policies for Alcohol in England. Results from the Sheffield Alcohol Policy Model Version 2008 (1.1). 2008, Sheffield: University of Sheffield, School of Health and Related Research (ScHARR) Public Health Collaborating Centre
Jones L, Bellis M, Dedman D, Sumnall H, Tocque K: Alcohol-Attributable Fractions for England Alcohol-Attributable Mortality and Hospital Admissions. 2008, Liverpool: North West Public Health Observatory, Centre for Public Health Research Directorate, Liverpool John Morres University
StataCorp: Stata Statistical Software: Release 12. 2011, College Station, TX, USA: StataCorp LP
Purchasing Power Parities (PPPs) Data. http://www.oecd.org/std/prices-ppp/purchasingpowerparitiespppsdata.htm,
Historic HICP harmonised inflation. http://www.inflation.eu,
Ministero della Salute: Medicina Generale, Ai Sensi Dell’art. 8 Del Decreto Legislativo 502/92 Come Modificato Dai Decreti Legeslativi N. 517/93 e N. 229/99. 1999, Rome, Italy: Ministero della Salute
Curtis L: Unit Costs of Health and Social Care. 2008, Canterbury, UK: Personal Social Services Research Unit, The University of Kent
Brignoli O, Cricelli C, Cricelli I, Innocenti F, Lapi F, Mazzaglia G, Niccolai C, Pasqua A, Pecchioli S, Sessa E, Simonetti M, Sini G: VI Report Health Search. 2010, Firenze, 53-54.
Hippisley-Cox J, Vinogradova Y: Trends in Consultation Rates in General Practice 1995/1996 to 2008/2009: Analysis of the QResearch Database. 2009, Nottingham, 1-24.
Struzzo P, Faccio S, De Moscatelli E, Scafato E: Identificazione precoce dei bevitori a rischio in Assistenza Primaria in Italia: adattamento del questionario AUDIT e verifica dell’efficacia d'uso dello short-AUDIT test nel contesto nazionale. Bolletino per le Farmacodipend e l’Alcoolismo. 2006, 29: 20-25.
Associazione Italiana di Economica Sanitaria (AIES): Proposta di linee guida per la valutazione economica degli interventi sanitari. PharmacoEconomics–Italian Res Artic. 2009, 11: 83-93. 10.1007/BF03320660. CrossRef
Tariq L, Van Den Berg M, Hoogenveen RT, Van Baal PHM: Cost-effectiveness of an opportunistic screening programme and brief intervention for excessive alcohol use in primary care. PLoS One. 2009, 4: 8-
Jonas DE, Garbutt JC, Brown JM, Amick HR, Brownley KA, Council CL, Viera AJ, Wilkins TM, Schwartz CJ, Richmond EM, Yeatts J, Evans TS, Wood SD, Harris RP: Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse. 2012
Keurhorst MN, Anderson P, Spak F, Bendtsen P, Segura L, Colom J, Reynolds J, Drummond C, Deluca P, van Steenkiste B, Mierzecki A, Kłoda K, Wallace P, Newbury-Birch D, Kaner E, Gual T, Laurant MG: Implementing training and support, financial reimbursement, and referral to an internet-based brief advice program to improve the early identification of hazardous and harmful alcohol consumption in primary care (ODHIN): study protocol for a cluster rando. Implement Sci. 2013, 8: 11-10.1186/1748-5908-8-11. CrossRefPubMedPubMedCentral
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