Historique
Article de Périodique
A microsimulation cost-utility analysis of alcohol screening and brief intervention to reduce heavy alcohol consumption in Canada (2016)
Auteur(s) :
ZUR, R. M. ;
ZARIC, G. S.
Année
2016
Page(s) :
817-831
Langue(s) :
Anglais
Refs biblio. :
94
Domaine :
Alcool / Alcohol
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus géographique
CANADA
Thésaurus mots-clés
ALCOOL
;
COUT
;
DEPISTAGE
;
INTERVENTION BREVE
;
REDUCTION DE CONSOMMATION
;
ABUS
;
MODELE
;
QUALITE DE VIE
;
MORTALITE
;
CAUSE DE DECES
Note générale :
Commentary: Cost-effectiveness of SBI for alcohol - where are we and where do we want to go? Barbosa C., Cowell A., p. 840-842.
Résumé :
Background and Aims: Screening and brief intervention (SBI) is a public health intervention that has been shown to be effective in reducing heavy alcohol consumption. The aim of this study is to estimate the cost-effectiveness of implementing universal alcohol SBI in primary care in Canada.
Design: We developed a microsimulation model of alcohol consumption and its effects on 18 alcohol-related causes of death.
Setting: The model simulates a Canadian population.
Participants: The model simulates individuals and their alcohol consumption on a continuous scale starting from age 17 years to death.
Interventions: The reference case assumes no SBI in Canada. The base case assumes screening was conducted using the Alcohol Use Disorders Identification Test (AUDIT) at a threshold score of 8. Additional analyses included evaluating SBI using the AUDIT at threshold scores between 4 and 8 or the Derived Alcohol Use Disorders Identification Test (AUDIT-C) at threshold scores between 3 and 7.
Measurements: The model estimates the direct health-care costs, life years gained and quality-adjusted life years (QALY) gained, which are then used to estimate the incremental cost-effectiveness ratio (ICER) of SBI versus no SBI.
Findings: SBI with AUDIT (at a threshold score of 8) had an ICER of $8729/QALY. Our results suggest that using AUDIT thresholds between 8 and 4, inclusive, would be cost-effective for the whole population, as well as for men and women individually. Our results suggest that the AUDIT-C would be cost-effective at thresholds of 7 to 3, inclusive, for men, women and the whole population.
Conclusions: In Canada, screening and brief intervention via Alcohol Use Disorders Identification Test (AUDIT) and Derived Alcohol Use Disorders Identification Test (AUDIT-C) to reduce heavy alcohol consumption appears to be cost-effective for men and women at Alcohol Use Disorders Identification Test (AUDIT) thresholds of 8 and lower and at Derived Alcohol Use Disorders Identification Test (AUDIT-C) thresholds of 7 and lower.
Design: We developed a microsimulation model of alcohol consumption and its effects on 18 alcohol-related causes of death.
Setting: The model simulates a Canadian population.
Participants: The model simulates individuals and their alcohol consumption on a continuous scale starting from age 17 years to death.
Interventions: The reference case assumes no SBI in Canada. The base case assumes screening was conducted using the Alcohol Use Disorders Identification Test (AUDIT) at a threshold score of 8. Additional analyses included evaluating SBI using the AUDIT at threshold scores between 4 and 8 or the Derived Alcohol Use Disorders Identification Test (AUDIT-C) at threshold scores between 3 and 7.
Measurements: The model estimates the direct health-care costs, life years gained and quality-adjusted life years (QALY) gained, which are then used to estimate the incremental cost-effectiveness ratio (ICER) of SBI versus no SBI.
Findings: SBI with AUDIT (at a threshold score of 8) had an ICER of $8729/QALY. Our results suggest that using AUDIT thresholds between 8 and 4, inclusive, would be cost-effective for the whole population, as well as for men and women individually. Our results suggest that the AUDIT-C would be cost-effective at thresholds of 7 to 3, inclusive, for men, women and the whole population.
Conclusions: In Canada, screening and brief intervention via Alcohol Use Disorders Identification Test (AUDIT) and Derived Alcohol Use Disorders Identification Test (AUDIT-C) to reduce heavy alcohol consumption appears to be cost-effective for men and women at Alcohol Use Disorders Identification Test (AUDIT) thresholds of 8 and lower and at Derived Alcohol Use Disorders Identification Test (AUDIT-C) thresholds of 7 and lower.
Affiliation :
Richard Ivey School of Business, The University of Western Ontario, London, Ontario, Canada
Cote :
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