The Economic Burden of Alcohol in Belgium: Incremental Healthcare and Indirect Costs

OBJECTIVES: In Belgium, 76.6% of the population over the age of 15 regularly consume alcohol. Alcohol use is known to be associated with a high disease burden, resulting in economic consequences. Therefore, the aim of the study was to provide a contemporary overview of the direct medical and indirect costs attributable to alcohol in Belgium.

METHODS: Data from the Belgian Health Interview Survey (BHIS) was combined with health insurance claims data (reference year 2018). Healthcare costs were calculated on individuals’ alcohol use patterns (abstainers, former drinkers, current drinkers). Lost productivity costs (i.e. cost of absenteeism) were calculated by multiplying the number of absence days by the national average wage cost per day in Belgium. Univariate and multivariable regression analysis with negative binomial distribution and log link were performed to evaluate the average healthcare costs and indirect costs in relation to alcohol consumption, sociodemographic characteristics, and (behavioural) risk factors. Incremental costs were calculated using the G-computation method.

RESULTS: A total of 10,829 individuals were included in the analyses, of which 47.7% were men with 76% indicating that they currently drink alcohol. On average, slightly more men reported that they drink alcohol compared with women (51% vs. 49%; P<0.001). Significant lower incremental medical costs were found for drinkers (-€347; P=0.002) compared with abstainers. In contrast, former drinkers had higher direct medical costs (€1025; P=0.02). Taking into account that 16% of the Belgian population were former drinkers in 2018, the national cost for former drinkers equates to €1,865,675,480. No significant differences according to alcohol use patterns were observed for the indirect costs.

CONCLUSIONS: Results of our study show that former alcohol users have on average higher direct medical costs compared with abstainers. No significant differences were found for productivity losses.