Historique
Article de Périodique
Comparative cost-effectiveness of policy instruments for reducing the global burden of alcohol, tobacco and illicit drug use (2006)
Auteur(s) :
CHISHOLM, D. ;
DORAN, C. ;
SHIBUYA, K. ;
REHM, J.
Année :
2006
Page(s) :
553-565
Langue(s) :
Anglais
Refs biblio. :
48
Domaine :
Alcool / Alcohol ; Drogues illicites / Illicit drugs ; Tabac / Tobacco / e-cigarette
Discipline :
SAN (Santé publique / Public health)
Thésaurus mots-clés
ALCOOL
;
DESINTOXICATION
;
TABAC
;
PRODUIT ILLICITE
;
COUT SOCIAL
;
EFFICACITE
;
POLITIQUE
;
SANTE PUBLIQUE
;
ACCOMPAGNEMENT
;
CURE DE DESINTOXICATION
;
SUBSTITUTION
;
MODELE STATISTIQUE
;
LUTTE
;
ECONOMIE
Thésaurus géographique
AMERIQUE
;
EUROPE
;
ASIE
;
ETATS-UNIS
;
AUSTRALIE
Résumé :
Alcohol, tobacco and illicit drug use together pose a formidable challenge to international public health. Building on earlier estimates of the demonstrated burden of alcohol, tobacco and illicit drug use at the global level, this review aims to consider the comparative cost-effectiveness of evidence-based interventions for reducing the global burden of disease from these three risk factors. Although the number of published cost-effectiveness studies in the addictions field is now extensive (reviewed briefly here) there are a series of practical problems in using them for sector-wide decision making, including methodological heterogeneity, differences in analytical reference point and the specificity of findings to a particular context. In response to these limitations, a more generalised form of cost-effectiveness analysis (CEA) is proposed, which enables like-with-like comparisons of the relative efficiency of preventive or individual-based strategies to be made, not only within but also across diseases or their risk factors. The application of generalised CEA to a range of personal and non-personal interventions for reducing the burden of addictive substances is described. While such a development avoids many of the obstacles that have plagued earlier attempts and in so doing opens up new opportunities to address important policy questions, there remain a number of caveats to population-level analysis of this kind, particularly when conducted at the global level. These issues are the subject of the final section of this review. [Review's abstract]
Affiliation :
Costs, Effectiveness, Expenditures and Priority-setting, Department of Health System Financing, Evidence and Information for Health Policy, World Health Organisation, 1211 Geneva 27
Suisse. Switzerland.
Suisse. Switzerland.