Guidelines and reality in studies on the economic costs of alcohol use: a systematic review

Sinclair Carr Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Jürgen Rehm Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Institute for Mental Health Policy Research and Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation Jakob Manthey Centre for Interdisciplinary Addiction Research, Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany

Keywords: Alcohol, Cost of illness, Guidelines, Methodology, Economic costs

Abstract

Aim: To identify guidelines for estimating alcohol-attributable cost of illness (COI) and actual COI studies, and to assess to what extent core recommendations have been implemented.

Design: The systematic review was conducted in February 2019 according to the PRISMA statement. Relevant COI guidelines and actual alcohol COI studies published since 2009 (when the last systematic review was published) were identified by searching databases MEDLINE and EMBASE, as well as literature known by the authors.

Measures:  Standards and recommendations of published COI guidelines, and actual COI studies estimating the total costs of alcohol.

Findings: Fourteen guidelines and eighteen COI studies were identified, and relevant indicators were extracted. Large discrepancies between recommended and implemented methods were determined. Contrary to most current guidelines, which were barely acknowledged at all, (a) predefined direct and indirect cost groups were only partially included, (b) estimates were compared with GDP in only about half of the studies, and (c) avoidable costs – a complementary concept to the more common scenario of complete alcohol abstinence – were never estimated.

Conclusions: Adherence to guidelines in published COI studies is low. We propose content-related and software-based solutions to adopting a common standard, which could reduce heterogeneity and enhance comparability in alcohol COI studies.

How to Cite

Carr, S., Rehm, J., & Manthey, J. (2021). Guidelines and reality in studies on the economic costs of alcohol use: a systematic review. The International Journal of Alcohol and Drug Research, 9(1), 3–13. https://doi.org/10.7895/ijadr.283

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