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Economic evaluations of alcohol prevention interventions: Is the evidence sufficient? A review of methodological challenges

Hill, Sarah R.; Vale, Luke; Hunter, David; Henderson, Emily; Oluboyede, Yemi

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Sarah R. Hill

Luke Vale

David Hunter

Emily Henderson

Yemi Oluboyede


Public health interventions have unique characteristics compared to health technologies, which present additional challenges for economic evaluation (EE). High quality EEs that are able to address the particular methodological challenges are important for public health decision-makers. In England, they are even more pertinent given the transition of public health responsibilities in 2013 from the National Health Service to local government authorities where new agents are shaping policy decisions. Addressing alcohol misuse is a globally prioritised public health issue. This article provides a systematic review of EE and priority-setting studies for interventions to prevent and reduce alcohol misuse published internationally over the past decade (2006–2016). This review appraises the EE and priority-setting evidence to establish whether it is sufficient to meet the informational needs of public health decision-makers. 619 studies were identified via database searches. 7 additional studies were identified via hand searching journals, grey literature and reference lists. 27 met inclusion criteria. Methods identified included cost-utility analysis (18), cost-effectiveness analysis (6), cost-benefit analysis (CBA) (1), cost-consequence analysis (CCA) (1) and return-on-investment (1). The review identified a lack of consideration of methodological challenges associated with evaluating public health interventions and limited use of methods such as CBA and CCA which have been recommended as potentially useful for EE in public health. No studies using other specific priority-setting tools were identified.

Journal Article Type Article
Acceptance Date Oct 18, 2017
Online Publication Date Oct 27, 2017
Publication Date Dec 1, 2017
Deposit Date Dec 19, 2017
Publicly Available Date Dec 20, 2017
Journal Health Policy
Print ISSN 0168-8510
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 121
Issue 12
Pages 1249-1262
Keywords Economic evaluation, Public health, Alcohol interventions, Priority-setting, Health economics, Methodological challenges.
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