Health Economic Assessment of Public Health Strategies for Alcohol Harm Reduction: The Sheffield Alcohol Policy Model Framework

P Meier, A Brennan, Y Meng, R Pursehouse, R Rafia, DH Macmanus

Summary

Alcohol is known to cause substantial harms, and controlling its affordability and availability are effective policy options. Such controls have impact on consumers, health services, crime, employers and industry, so a sound evaluation of impact is important. This paper sets out the development of a methodological framework for detailed evaluation of public health strategies for alcohol harm reduction to meet UK policy-makers needs. We discuss the iterative process to engage with stakeholders, identify evidence/data and develop model structure. We set out a series of steps in modelling impact including: classification and definition of population subgroups of interest, identification and definition of harms and outcomes for inclusion, classification of modifiable
components of risk and their baseline values, specification of the baseline position on policy variables especially prices, estimating effects of changing policy variables on risk factors including price elasticities, quantifying risk functions relating risk factors to harms including 47 health conditions, crimes, absenteeism and unemployment, and monetary valuation. The most difficult model structuring decisions are described, as well as the final results framework used to provide decision support to national level policymakers in the UK. In the discussion we explore issues around valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions, and ongoing plans for further development.