Social Science and Medicine 52 (2001) 863–870 Cost effectiveness of brief interventions for reducing alcohol consumption Sonia E. Wutzke a, *, Alan Shiell b , Michelle K. Gomel a , Katherine M. Conigrave c a Department of Psychological Medicine, University of Sydney, Australia b Social and Public Health Economics Research Group (SPHERe), Dept of Public Health and Community Medicine, University of Sydney, Australia c Drug and Alcohol Department, Central Sydney Area Health Service, Royal Prince Alfred Hospital, and Department of Psychological Medicine, University of Sydney, Australia Abstract The direct costs and health effects of a primary-care-based brief intervention for hazardous alcohol consumption were examined. The total cost of the intervention was calculated from costs associated with: marketing the intervention programme; providing training and support in the use of the intervention materials; physician time required for providing brief advice for ‘at-risk’ drinkers. The effect of the intervention on health outcomes was expressed in terms of number of life years saved by preventing alcohol-related deaths. This was derived by combining estimates of the impact of the programme if it were implemented nationally with available evidence on the health effects of excess alcohol consumption. Results are based on international trial evidence showing the physical resources required by the intervention and its effectiveness combined with Australian price data. The costs associated with screening and brief advice using the current intervention programme range from Aus$19.14 to Aus$21.50. The marginal costs per additional life year saved were below Aus$1873. The robustness of the model used is supported by an extensive sensitivity analysis. In comparison with existing health promotion strategies the costs and effects of the current intervention are highly encouraging. # 2001 Elsevier Science Ltd. All rights reserved. Keywords: Brief intervention; Alcohol; Primary health care; Cost effectiveness Introduction The physical, psychological and social harms of excessive alcohol use represent an important public health problem and contribute a significant strain on scarce health care resources. Excessive alcohol con- sumption is responsible for a 3–7-fold increase in premature mortality (Andreasson, Allebeck & Romels- jo, 1988; Kristenson, 1987; Lambie, Whiteside, Bell & Johnson, 1983) with an estimated 6000 deaths each year in Australia alone (Holman, 1994). Additionally, the net cost incurred by the Australian community as a result of alcohol use is estimated to exceed Aus$6 billion annually (Collins & Lapsley, 1992). The World Health Organization (WHO) Collabora- tive Study on Identification and Management of Alcohol Related Problems in Primary Health Care (PHC) commenced in 1983 and to date has involved 21 countries in Australasia, Europe and North America. The first phase of this work resulted in the development of a valid screening instrument designed to identify hazardous alcohol use (the Alcohol Use Disorders Identification Test; AUDIT) with sensitivity and speci- ficity of 93% and 82% respectively (Saunders, Aasland, Babor, De La Fuente & Grant, 1993). The second phase assessed the effectiveness of a brief intervention to reduce alcohol consumption and established that brief *Corresponding author. Drug and Alcohol Services, Building 82 RPAH, Missenden Rd, Camperdown NSW 2050, Australia. Tel.: +61-2-9515-8972; fax: +61-2-9515-8970. E-mail address: swutzke@med.usyd.edu.au (S.E. Wutzke). 0277-9536/01/$ - see front matter # 2001 Elsevier Science Ltd. All rights reserved. PII:S0277-9536(00)00189-1