The cost-effectiveness of increasing alcohol taxes: a modelling study

The chronic disease model of the National Institute for Public Health and the Environment was used to extrapolate from decreased alcohol consumption due to tax increases to effects on health-care costs, life-years gained and quality-adjusted life-years gained, 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 with 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, quality-adjusted life-years gained, and health-care costs.In the Swedish scenario, many more quality-adjusted life-years were gained than in the Dutch scenario, but both scenarios had almost equal incremental cost-effectiveness ratios: €5100 per quality-adjusted life-year and €5300 per quality-adjusted life-year, respectively.Focusing on health-care costs and health consequences for drinkers, an alcohol tax increase is a cost-effective policy instrument.Excessive alcohol use is a cause of morbidity and mortality as it 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 [1,2]. Moreover, excessive alcohol consumption is associated with (intentional and unintentional) injuries [2,3]. In Europe, the average alcohol consumption is about 11–13 litres of pure alcohol per adult per year [3,4]. Currently about 14% of Dutch men aged 12 and over drink more than three alcoholic consumptions per day and about 10% of Dutch women aged 12 and over drink more than two alcoholic consumptions per day [5]. As a consequence of these drinking patterns, almost 7% of the burden of disease in Western Europe is alcohol related [1,2]. In the Netherlands, about 1% of the mortality, 4.5% of the burd