Methodologies of Cost-of-Illness Studies on Alcohol by InternationalSystematic Review and Costs Impacted by Intervention of Reduced Drinkingin Japan

Abstract

Objectives: This study was aimed to analyze cost components and underlying methods of cost-of-illness (COI) studies on alcohol in Japan and overseas by international systematic review, to estimate direct and indirect costs attributable to alcohol in Japan with new data, and to estimate costs impacted by reduced drinking among high-risk drinkers in Japan. Methods: Relevant publications concerning COI studies on alcohol published during the years 2005-2014 were identified through PubMed and Embase. Google search was conducted to identify relevant studies based on references of other relevant publications. Japanese COI studies on alcohol were identified through Igaku-Chuo-Zasshi (Ichushi) database without limiting the publication year. Cost components and underlying methods were analyzed, and medical costs attributed to alcohol were calculated based on 2012 government data and alcohol-attributed fractions (AAFs), then costs impacted by reduced drinking in Japan were estimated. Results: Seven eligible studies on 7 countries including Japan met inclusion criteria. All the countries calculated direct and indirect costs associated with alcohol, while only 2 foreign countries further calculated intangible costs. Indirect and intangible costs were 2.5-4 times larger than direct costs in all countries. Medical care costs attributed to alcohol in Japan based on 2012 data and AAFs were 1.5 times higher than 25 years ago. Furthermore, decreased number of high-risk drinkers in Japan in achieving the second term goal of Health Japan 21 was estimated to save 363.1 billion yen per year. Conclusions: Despite methodological challenges of COI studies, it is still valuable to estimate direct and indirect costs attributable to alcohol in Japan, and related costs possibly saved by reduced drinking highlighted the importance of expanding brief interventions in a clinical setting in Japan.