Modeling the potential health, health economic, and health inequality impact of a large-scale rollout of the drink less app in England

Objectives: Alcohol places a significant burden on the National Health Service (NHS); yet, uptake of cost-effective approaches remains low. Digital interventions may overcome some barriers to delivery. The Drink Less app has evidence of being effective at supporting heavier drinkers to reduce their alcohol intake. In this study, we estimate the longer-term health impacts, cost-effectiveness, and health inequality impact of a large-scale rollout of the Drink Less app.

Methods: We used the Sheffield Alcohol Policy Model to estimate changes in alcohol consumption, hospital admissions, mortality, and NHS costs of 2 rollout scenarios over a 20-year time horizon: (1) a mass media awareness campaign and (2) a targeted drive to embed referral to Drink Less within primary care. We modeled the cost-effectiveness and inequality impact of each approach in a distributional cost-effectiveness analysis.

Results: A mass media campaign is estimated to reduce per capita alcohol consumption by 0.07 units/week and avert 108 556 hospital admissions and 2606 deaths over 20 years, gaining 24 787 quality-adjusted life-years at a net saving to the NHS of £417 million. Embedding in primary care is estimated to reduce consumption by 0.13 units/week, saving 188 452 admissions and 4599 deaths and gaining 38 897 quality-adjusted life-years at a net saving of £590 million. Both scenarios are estimated to reduce health inequalities, with a larger reduction for the primary care approach.

Conclusions: A large-scale rollout of the Drink Less app is estimated to be health improving, cost saving, and reducing health inequalities. Embedding the use of Drink Less within primary care is likely to be the more effective approach.