– What is the policy question?– What costs and benefits are included?– Some examples– How easy are they to replicate in
– Costs can be just those costs falling on
governments, these costs with any otherimpacts generally given in money terms or anyimpact that can be valued in money terms forexample loss of life, fear of crime
– Private borne by individuals/families– External borne by others– Social = private + external
– What are the costs of alcohol at a specific
time period compared to the situation wherethere was no alcohol?
– Is there evidence that there are excess costs
– Is a policy good value for money compared to
– Both revenue and welfare benefits are
Benefits of having an alcohol industry
– Jobs and other “benefits” of an industry follow
consumer spending patterns and not seen as
independent – as consumers spend differently
Could argue main costs of loss of life to individual
drinkers and their families and should be excluded
Argument is that loss of life is a loss of
productive worth in an economy – productivityloss. Valued by loss of life time earnings
But this valuation gives lower value to women,
Could argue that loss of life is a “cost” to the
whole society and value by “willingness to pay” –yields much higher values £1,144,890 comparedto £147,187 for UK
Can be a substantial research exercise
But for health, international reviews and
Crime and workplace costs need local data
Figures can be used for other types of
Question is at a moment in time, with
current alcohol policies, is there evidenceof excess costs.
Part of the study may be to compare any
Implications of different assumptions: 1.
There is a case for ignoring individual
Economic models are generally based on
therefore family consequences may also be
Policies that lead to an involuntary change
Alcohol consumers are not aware of the
consequences and therefore cannot act intheir own best interests – there is apotential gain in overall welfare (reductionin social costs) if governments act toreduce consumption
Models would therefore include a value for
the costs to individuals and their families
At the extreme end if people cannot make
rational decisions and get no benefit fromtheir consumption, the resources beingdevoted to the production and distributionof the goods consumed in thesecircumstances could yield more socialbenefits if used for some other good
However, some would argue that addiction
does not preclude all benefit or all choice –the rational addiction model
Clear economic case for policy action
as cost of illness with addition ofmany private costs, e.g. Fenoglio et al(2003)
What are all the costs and consequences
Most developed in health care fields,
explicit cost effectiveness criteria in a
treatment – benefits greater than costs –
industry e.g. school education costly and
Expensive well conducted research studies
Add on studies to existing research, e.g.
Modelling using systematic reviews of the
data and local resource estimates, e.g. Slattery et al (2003)
Example of local policy simulation - Scottish
Treatment Simulation (Slattery et al, 2003)
Net health care cost perdeath averted, £
Estimating the financial burden of alcohol
through cost of illness studies is a way of
sacrificed to the issue of current financial
many interventions, even of limitedeffectiveness, save resources
needed, a lot can be done withlimited data
To Anticoagulate or not to Anticoagulate? A Common Dilemma for the Provider: Physicians’ Opinion Poll Based on a Case Study of an Older Long-term Care Facility Resident With Dementia and Atrial Fibrillation T.S. Dharmarajan, MD, FACP, AGSF, Surendran Varma, MD, Shailaja Akkaladevi, MD, Anna S. Lebelt, MD, andEdward P. Norkus, PhD, FACN Objective: Anticoagulation therapy is an acceptableT
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