2. Quality of life of alcohol-related diseases and road accidents in Switzerland: An economic assessment France Priez The University of North Carolina at Chapel Hill Neuchâtel October 24th 2003

3. Social cost of substance abuse Economic costs Direct costs Indirect costs Quality of life Burden for the society resulting from substance abuse and expressed in monetary units

4. Quality of life and alcohol abuse Impact on health e.g. Road accidents Diseases Impact on behavior e.g. Drunkeness Addiction

5. Impact of accidents and diseases on quality of life Physical consequences Psychological impact Changes in life style Loss of life (if death)

6. Selection of diseases

7. How to measure quality of life Survey Ask participants to tell what is their quality of life with specific accidents or diseases Monetary measure = human costs Willingness to pay to avoid accident or disease Scale = utility index Full health = 1, Death = 0, Specific condition = ?

8. Methods Welfare Economics Expressed preferences 1.Contingent valuation 2.Standard gamble

9. Contingent Valuation Only for ENT cancer and hypertension (+ road accidents from former study) Describe health condition and main risk factors Present the average risk of suffering from such condition by gender Contingent market: How much are you willing to pay to reduce your risk of suffering from such disease or having such accident

10. Standard Gamble For ENT cancer, hypertension, liver cirrhosis and chronic pancreatic Quality of life measured by a utility index between 1 (full health) and 0 (death) Death Full health No treatment = Health condition Treatment p 1- p Decision

11. Methodological decisions Selection and description of diseases Pre-tests, in-depth interviews Target population: general population Health as private good Ex-ante estimation Sensitivity analysis: risk variations of 95% & 50% Face-to-face interview Quotas sampling

12. Two-step estimation 1 st step (ENT cancer and hypertension) Contingent valuation and standard gamble Human costs = - f [ utility index ] 2 nd step (liver cirrhosis and chronic pancreatic) Standard gamble only Plug utility index in above function to get human costs

13. Quota sampling Reasons: face-to-face interviews & visual cards Representative sample of Swiss population 18+ Four quotas: – Gender – Rural versus urban – Age group – Socio-economic category

14. Sample sizes

15. Mean utility index of alcohol-related diseases

16. Mean human costs of alcohol-related diseases

17. Total human costs of alcohol-related diseases and road accidents in Switzerland in 1998 Economic costs2,191.7

18. The End

19. Sample characteristics

20. Contingent Valuation (2) Advantages – Theoretical foundations – Flexible – Price of non-market goods Disadvantages –‘Fictive’ market – Potential biases – Potentially all costs faced by individuals

21. Standard Gamble (2) Advantages – Theoretical foundations – Measures quality of life only – No direct link with income Disadvantages –‘Fictive’ market – Potential biases – No direct monetary value

22. Utility index and human costs of alcohol-related diseases

23. Alcohol-related road accidents in Switzerland in 1998