Estimating health care cost of alcoholism in France: contributions and limitations of two evaluation methods

Two calculation schemes: We estimated the cost of health care related to al coholism using two different medicoeconomic approaches. Prevalence of alcoholism: Corresponding costs of alcohol-related conditions can be calculated from the prevalence of alcoholism in hospitalized and am bulatory patients. It is however impossible to calculate the alcohol-relate d cost, even for heavy drinkers, when alcohol is involved as a risk factor. Method one: For a 10% prevalence of excessive alcohol intake in the general population, the minimal cost in 1996 would be approximately 14 billion fra ncs ($2.2 billion). For a 15% prevalence, it would reach 16 billion ($2.6 b illion). This cost only concerns diseases directly or indirectly related to alcoholism. The estimated hospital cost of diseases directly related to al coholism, that is alcoholic dependence and psychosis, cirrhosis, and upper airway-digestive cancers, reaches 6 to 6.5 billion francs ($1 - $1.03 billi on) respectively for a 10 or 15% prevalence Total costs (hospital and ambul atory costs) are between 6.4 and 6.9 billion francs ($ 1.02 - $1.04 billion ). For diseases where alcohol is only a risk factor the minimal cost varies between 7.5 and 9.5 billion francs ($1.20 -$ 1.51 billion). I Method two: With this method, the minimal total cost is to the order of 20 billion francs ($3.75 billion) with half being hospital costs and half ambu latory costs. This cost only concerns alcohol in overt disease slates. Cost s related to alcohol as a risk factor are not included iii this estimation as there is no known coefficient for attribution. High cost of alcoholism: Both of our methods used a minimizing estimation s cheme and found total costs to lie in the range of 15 (n) over tilde 20 bil lion francs ($2.38 - $3.75 billion). Extrapolating from studies conducted i n other countries where social costs amounted to 75% of total costs, it can be considered that alcoholism in France cost more than 80 billion francs ( $12.7 billion) a figure exceeding 1% of the CNP.