A 45p minimum unit price would save more than 600 deaths and 23,700 hospital admissions a year – compared to just 14 deaths and 500 admissions under the ban of below cost selling, according to the modelling study published by the BMJ this week.
In particular, a minimum pricing policy would be a more effective way to address the category of ‘harmful’ drinkers, the study adds.
‘Small effect’ from ban on below cost selling
Increasing the price of alcohol is considered to reduce consumption level and harm. The government’s ban on below cost selling, implemented in England in May, means the selling price to consumers cannot be lower than tax payable on the product.
However, researchers say this policy affects just 0.7% of alcohol units currently sold and is estimated to have ‘small effects’ on consumption and health harm. This compares to 23.2% of units for a 45p minimum unit price.
“The proportion of the market that would be affected by price regulation is the key driver of the scale of estimated policy impact,” said Alan Brennan, professor of health economics and decision modelling, and one of the authors of the study.
A policy of minimum unit pricing was considered by the UK government in 2012, with a base price of 40p – 50p per unit of alcohol discussed, but was withdrawn in 2013. Researchers say that, at these levels, minimum unit pricing is estimated to have approximately 40-50 times greater effect than a ban on below cost selling.
“The ban on below cost selling has a small effect on population health—saving an estimated 14 deaths and 500 admissions to hospital per annum,” said Brennan. “In contrast, a 45p minimum unit price is estimated to save 624 deaths and 23 700 hospital admission.”
The study used the Sheffield Alcohol Policy Model (version 2.5), which took data from the general lifestyle survey 2009 on consumption. It considered 96 subgroups which took factors such as age, sex, consumption level (moderate, hazardous, and harmful) and income into account.
Effect on harmful drinkers
The greatest effect of a 45p minimum unit price policy would be seen among harmful drinkers, researchers say.
“Below cost selling is estimated to reduce harmful drinkers’ mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45p minimum unit price (approximately 45 times greater effect),” said Brennan.
“Under a minimum unit price policy, the minimum selling price increases in proportion to the alcohol units contained in the drink (1 unit=7.9 g/10 mL of pure ethanol).
"Therefore this measure would target those drinks that are high in alcohol content and sold relatively cheaply: drinks that are favoured more by those drinking at harmful levels.”
Of the population aged 16 or more, 25.5m (61.5%) are moderate drinkers, 7.2m (17.3%) are hazardous drinkers, and 2.2m (5.3%) are harmful drinkers.
“The proportion of alcohol affected by a minimum unit price varied across these subgroups: for example, a 45p minimum unit price would affect 12.5%, 19.5%, and 30.5% of units sold to moderate, hazardous, and harmful drinkers, respectively.
"In contrast, the impact of a ban on below cost selling on all drinkers would be minimal, and just 1.0% of units currently consumed by harmful drinkers would be affected.”
Published September 30, 2014. DOI: http://dx.doi.org/10.1136/bmj.g5452
‘Potential benefits of a minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study’
A Brennan, J Holmes, D Hill-McManus, P Meier.