Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Drug Policy. 2019 Jul;69:34-42. doi: 10.1016/j.drugpo.2019.04.005. Epub 2019 May 2.
The health and economic consequences of alcohol consumption have been assessed mainly in developed countries. This study aims to estimate health impact and economic burden attributable to alcohol use in India.
A combination of decision tree and mathematical markov model was parameterized to assess the health effects and economic cost attributable to alcohol consumption. Health effect of alcohol was modelled for a time period of 2011 to 2050 on three sets of conditions - liver disease, cancers and road traffic accidents. Estimates of illness, death, life years lost and quality adjusted life years (QALYs) gained were estimated as a result of alcohol consumption. Both direct and indirect costs were estimated to determine economic burden. Future costs and consequences were discounted at 3% for time preferences of cost and utility. Uncertainties in parameters were assessed using probabilistic sensitivity analysis.
Between 2011 and 2050, alcohol attributable deaths would lead to a loss of 258 million life years. In contrast, 552 million QALYs would be gained by eliminating alcohol consumption. Treatment of these conditions will impose an economic burden of INR 3127 billion (US$ 48.11 billion) on the health system. Societal burden of alcohol, inclusive of health system cost, out of pocket expenditure and productivity losses will be INR 121,364 billion (US$ 1867 billion). Even after adjusting for tax receipts from sale of alcohol, alcohol poses a net economic loss of INR 97,895 billion (US$ 1506 billion). This amounts to an average loss of 1.45% of the gross domestic product (GDP) per year to the Indian economy.
Alcohol causes significant negative health impact and economic burden on Indian society and evidence informed policy interventions are needed to control alcohol attributable harm.
酒精消费对健康和经济造成的后果主要在发达国家进行了评估。本研究旨在评估印度因饮酒而产生的健康影响和经济负担。
采用决策树和数学马尔可夫模型相结合的方法，对饮酒导致的健康影响和经济成本进行参数化评估。在 2011 年至 2050 年期间，对三种情况——肝病、癌症和道路交通事故——进行了酒精对健康影响的建模。根据饮酒造成的疾病、死亡、生命年损失和质量调整生命年（QALY）获益来评估估计。对直接和间接成本进行了估计，以确定经济负担。为了考虑成本和效用的时间偏好，未来成本和后果以 3%的贴现率进行贴现。使用概率敏感性分析评估参数的不确定性。
在 2011 年至 2050 年期间，酒精导致的死亡将导致 2.58 亿生命年的损失。相比之下，消除酒精消费将带来 5.52 亿 QALY 的收益。治疗这些疾病将给卫生系统带来 31270 亿印度卢比（481.1 亿美元）的经济负担。包括卫生系统成本、自付支出和生产力损失在内的酒精造成的社会负担为 1213640 亿印度卢比（18670 亿美元）。即使考虑到酒精销售的税收收入，酒精仍会造成 97895 亿印度卢比（15060 亿美元）的净经济损失。这相当于印度经济每年国内生产总值（GDP）的 1.45%的平均损失。
酒精对印度社会造成了重大的负面健康影响和经济负担，需要采取循证政策干预措施来控制酒精造成的伤害。
