The costs of hazardous alcohol consumption in Germany

Abstract

Hazardous alcohol consumption in Germany is a main threat to health. By using insurance claim data from the German Statutory Health Insurance and a classification strategy based on ICD10 diagnoses-codes we analyzed a sample of 146,000 subjects with more than 19,000 hazardous alcohol consumers. Employing different regression models with a control function approach, we calculate life years lost due to alcohol consumption, annual direct and indirect health costs, and the burden of pain and suffering measured by the Charlson-Index and assessed pain diagnoses. Additionally, we simulate the net accumulated premium payments over expenses in the German Statutory Health Insurance and the Statutory Pension Fund for hazardous alcohol consumers from a lifecycle perspective. In total, €39.3 billion each year result from hazardous alcohol consumption with an average loss of 7 years in life expectancy. Hazardous alcohol consumers clearly do not "pay their way" in the two main German social security systems and also display a higher intangible burden according to our definitions of pain and suffering.

Production Losses Associated with Alcohol-Attributable Mortality in the European Union

“…Only in the last 15 years, several systematic reviews on the economic impact of alcohol consumption [4,8,10,14], heavy drinking and alcohol dependence [9,15] have been published. Studies from individual states include both estimates from high-income countries (e.g., Belgium [12,16], the United States [11,17], Germany [18,19,20], the United Kingdom [13,21], Estonia [22] and Portugal [23]) and middle-income states (e.g., Russia [24], Sri Lanka [25] and Thailand [26]). Despite this abundance of evidence, the comparability of findings from particular countries is extremely limited because of methodological heterogeneity (different definitions, data sources, cost categories and calculation methods), resulting in a broad range of estimates [8,9].…”

“…Clearly, the cost of mortality constitutes only a single component of alcohol economic burden; however, several cost-of-illness studies show that its magnitude is considerable. The cost of mortality constituted the following shares of total alcohol-attributable costs (or production losses): 27.0% (or 35.2%) in Germany [19]; 30.2% (42.0%) in the US [11]; 43.8% (61.8%) in Belgium [12]; 45.0% (68.8%) in another study from Germany [18] and as much as 66.7% (69.6%) in Thailand [26]. These figures show that mortality is a major burden category in the cost of alcohol misuse.…”

Potenzielle Auswirkungen erhöhter Alkoholsteuern auf die alkoholbedingte Krankheitslast in Deutschland: Eine Modellierungsstudie

“…39,3 Mrd. € geschätzt [ 41 ]. Den hohen ökonomischen sowie gesellschaftlichen Kosten von Alkohol steht dabei eine liberale Alkoholpolitik gegenüber, in der evidenzbasierte Empfehlungen der WHO zur Reduzierung der alkoholbedingten Krankheitslast nur unzureichend berücksichtigt werden.…”

The effect of alcohol sales restrictions on alcohol poisoning mortality: Evidence from Russia

“…To the best of my knowledge, such an important consequence of alcohol use as alcohol poisoning mortality has not been recently studied in connection with alcohol legislation in either developed, or developing countries with traditionally higher levels of alcohol mortality. The literature on alcohol mortality suggests that factors increasing alcohol consumption also lead to higher levels of indirect alcohol‐related mortalities (see, e.g., Carpenter & Dobkin, 2009; Kopp & Ogrodnik, 2017; and Effertz et al., 2017 for evidence for the United States, France, and Germany, respectively). In the context of alcohol‐related mortality, Law and Marks (2019) examine the prohibition policies conducted in the United States between 1900 and 1920 with results suggesting the effectiveness of the policies.…”