Estimating the economic effects of reduced drinking in Japan based on the methodologies of cost-of-illness studies on alcohol in Japan and overseas.

One of the alcohol-related goals in Japan's health promotion campaign called Health Japan 21 (secondary term) is to reduce the number of high-risk drinkers (20 years old or above) who consume 40g or more pure alcohol/day in men and 20g or more in women by year 2022. To achieve this goal, it is important for both the government and clinicians to understand the cost-of-illness associated with harmful drinking in Japan and .effectively reflect it into related poli- cies. In this study, direct and indirect costs attributable to alcohol based on conventional cost-of-illness study methodologies were estimated to be approximately 9.9 trillion yen using 2012 data. Furthermore, economic effects brought by achieving the goal of Health Japan 21 (seconda'ry term) were further analyzed by incorporating parameters such as employment rates, drinking volume and frequency by age group and gender. The authors.had previously estimated possible savings of as much as 381.3 billion yen, before subtracting associated intervention costs and decreased tax revenue from purchasing alcohol beverages. The scenario analysis in this study provided lower savings of approximately 158.4-194.6 billion yen. However, the estimates excluded high-risk drinkers in their 20s, early 30s and over 70, who account for a good part of high-risk drinkers in Japan. Furthermore, considerations of employment rates and average annual salaries into the calculations of economic loss due to premature mortality tend to ignore productivity loss (absenteeism and presentism) of high-risk drinkers and opportunity costs of home-makers or care-givers. Thus, possibly underestimated 158.4 billion yen was considered as realistic as possibly overestimated 381.3 billion yen. Despite such variations, economic effects brought by achieving reduced drinking among high-risk drinkers seemed to support related policies and disease management in Japan.