|Titre :||A microsimulation cost-utility analysis of alcohol screening and brief intervention to reduce heavy alcohol consumption in Canada (2016)|
|Auteurs :||R. M. ZUR ; G. S. ZARIC|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.111, n°5, May 2016)|
|Article en page(s) :||817-831|
|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.|
|Discipline :||EPI (Epidémiologie / Epidemiology)|
Thésaurus TOXIBASEALCOOL ; COUT ; DEPISTAGE ; INTERVENTION BREVE ; REDUCTION DE CONSOMMATION ; ABUS ; MODELE ; QUALITE DE VIE ; MORTALITE ; CAUSE DE DECES
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.
|Domaine :||Alcool / Alcohol|
|Refs biblio. :||94|
|Affiliation :||Richard Ivey School of Business, The University of Western Ontario, London, Ontario, Canada|