Abstract
BackgroundAs 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.MethodsThe 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.ResultsModel 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.ConclusionsThis 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.
Highlights
As alcohol-related health problems continue to rise, the attention of policy-makers is increasingly turning to Screening and Brief Intervention (SBI) programmes
The outcome measures observed were the costs of screening, the reduction in costs to the Italian National Health Service (INHS) as a result of reduced morbidity and mortality and the improvement in health outcomes measured in Quality-Adjusted Life Year (QALY), in line with standard practice in Italian cost-effectiveness analyses [17]
The resulting incremental cost-effectiveness ratios for all scenarios suggest that either of the modelled SBI programmes would be highly cost-effective when compared with a policy of no SBI, under current Italian guidelines [43], with a policy of SBI at consultation using the current AUDIT-C 5/4 screening tool bringing the greatest net benefit of all modelled options
Summary
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 consider the Italian context. The attention of policymakers is increasingly turning to screening and brief intervention (SBI) programmes. We considered the uncertainty around the existing evidence by examining a range of sensitivity analyses, as well as investigating the impact of using alternative screening tools. Our results are compared with those of recent cost-effectiveness studies in other countries
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