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Open Access Research article

Cost-effectiveness of a programme of screening and brief interventions for alcohol in primary care in Italy

Colin Angus1*, Emanuele Scafato2, Silvia Ghirini2, Aleksandra Torbica3, Francesca Ferre3, Pierluigi Struzzo4, Robin Purshouse5 and Alan Brennan1

Author Affiliations

1 School of Health & Related Research (ScHARR), University of Sheffield, Sheffield, UK

2 Istituto Superiore di Sanità, Viale Regina Elena, Rome, Italy

3 Centre for Research on Health and Social Care Management (CERGAS) Bocconi University, Via Roentgen, Milan, Italy

4 Region Friuli Venezia Giulia, Regional Centre for the Training in Primary Care, Monfalcone, Italy

5 Department of Automatic Control & Systems Engineering, University of Sheffield, Sheffield, UK

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BMC Family Practice 2014, 15:26  doi:10.1186/1471-2296-15-26

Published: 6 February 2014

Abstract

Background

As alcohol-related health problems continue to rise, the attention of policy-makers is increasingly turning to Screening and Brief Intervention (SBI) programmes. The effectiveness of such programmes in primary healthcare is well evidenced, but very few cost-effectiveness analyses have been conducted and none which specifically consider the Italian context.

Methods

The Sheffield Alcohol Policy Model has been used to model the cost-effectiveness of government pricing and public health policies in several countries including England. This study adapts the model using Italian data to evaluate a programme of screening and brief interventions in Italy. Results are reported as Incremental Cost-Effectiveness Ratios (ICERs) of SBI programmes versus a ‘do-nothing’ scenario.

Results

Model results show such programmes to be highly cost-effective, with estimated ICERs of €550/Quality Adjusted Life Year (QALY) gained for a programme of SBI at next GP registration and €590/QALY for SBI at next GP consultation. A range of sensitivity analyses suggest these results are robust under all but the most pessimistic assumptions.

Conclusions

This study provides strong support for the promotion of a policy of screening and brief interventions throughout Italy, although policy makers should be aware of the resource implications of different implementation options.

Keywords:
Public health interventions; Alcohol; Primary care; Cost-effectiveness