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The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002

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Abstract

This article estimates the societal cost of alcohol consumption in Sweden in 2002, as well as the effects on health and quality of life. The estimation includes direct costs, indirect costs and intangible costs. Relevant cost-of-illness methods are applied using the human capital method and prevalence-based estimates, as suggested in existing international guidelines, allowing cautious comparison with prior studies. The results show that the net cost (i.e. including protective effects of alcohol consumption) is 20.3 billion Swedish kronor (SEK) and the gross cost (counting only detrimental effects) is 29.4 billon (0.9 and 1.3% of GDP). Alcohol consumption is estimated to cause a net loss of 121,800 QALYs. The results are within the range found in prior studies, although at the low end. A large number of sensitivity analyses are performed, indicating a sensitivity range of 50%.

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Notes

  1. A full account of methods, data and results are reported in Johansson et al. [7].

  2. The included diseases are malignant neoplasms (C00-C14, C15, C16, C22, C32, C50, D00-D48), diabetes (E10-E14), neuro-psychiatric conditions (F10, F32-F33, G31.2, G40-41, G62.1), cardiovascular diseases (I10-15, I20-I24, I25.1-I25.9, I42.6, I47-I49), cerebrovascular diseases (I60-I62, I63-I66, I85), digestive diseases (K29.2, K70, K74, K80, K85, K86.0, K86.1), skin disease (L40), conditions arising during the perinatal period (Q86.0, R78.0) and other diseases (E24.4, G72.1, O35.4, P04.3, T51, Z72.1).

  3. The complete ICD-10 chapters V, W, X and Y, divided into different causes of injuries.

  4. Adjustment by multiplying the AAF for traffic accidents by 2/3 and all other accidents by 4/9.

  5. The age groups used are 0-14, 15–17, 18–29, 30–49, 50–64, 65–79 and 80+.

  6. The groups are abstainers (no alcohol within last year), low consumption (women 0–19.99 g, men 0–39.99 g), hazardous consumption (women 20–39.99 g, men 40–59.99 g) and harmful consumption (women 40+ g, men 60+ g).

  7. Includes 1,500 respondents aged 16–80 each month.

  8. Mainly concerning motor vehicle, water traffic and drowning, and fire accidents as well as homicides.

  9. Additional costs as a consequence of crime are health care and productivity costs, which are accounted for under these headings.

  10. No longer a criminal offence, it involves the police with the task of bringing the person into a safe environment.

  11. No future costs are calculated for direct costs, thus no discount rate has been applied.

  12. Before taxes, i.e. including the contribution to the social welfare system.

  13. Early retirement can be granted fully or in part.

  14. Longer than 14 days and paid for by the national sickness insurance.

  15. The Swedish Survey of Living Conditions (ULF).

  16. http://www.who.int/substance_abuse/research_tools/en/english_whoqol.pdf

  17. Some figures differ between this article and the original report [7] due to minor corrections of mainly computational errors.

  18. The net per capita cost is equivalent to $243 and the gross to $352 (PPP USD).

  19. See Johansson et al. [7] for a full account of methods and results from all sensitivity analyses.

  20. Hybrid approach [12], friction cost method [40], cost in added life-years [41, 21], exclusion of non-market productivity and different valuations of non-market productivity.

  21. The method uses the difference between market production and market consumption at different ages as a value of lost life-years.

  22. 2,800 SEK per capita aged 15 and above.

  23. Where all credible analyses were in the range of 50% of the point estimate of 20.3 billion SEK.

  24. Human capital, hybrid, willingness-to-pay, and demographic method are employed in different studies.

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Acknowledgements

This project was funded by the Swedish Ministry for Health and Social Affairs and the Swedish Institute of Public Health (for Gerdtham).

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Jarl, J., Johansson, P., Eriksson, A. et al. The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002. Eur J Health Econ 9, 351–360 (2008). https://doi.org/10.1007/s10198-007-0082-1

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