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 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 two rollout scenarios over a 20-year time horizon: i) a mass media awareness campaign and ii) a targeted drive to embed referral to Drink Less within primary care. We modelled the cost-effectiveness and inequality impacts 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 2,606 deaths over 20 years, gaining 24,787 QALYs at a net saving to the NHS of £417m. Embedding in primary care is estimated to reduce consumption by 0.13 units/week, saving 188,452 admissions and 4,599 deaths and gaining 38,897 QALYs at a net saving of £590m. 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 to reduce health inequalities. Embedding the use of Drink Less within primary care is likely to be the more effective approach.