Minimum unit pricing may be an effective alcohol control policy in the UK

1. Minimum unit pricing was estimated to be 45-times more effective at reducing alcohol consumption levels than a ban on below cost selling.

2. Prevention of health harms was estimated to be 40-50 times greater with minimum unit pricing.

Evidence Rating Level: 2 (Good)      

Study Rundown: In recent years, the United Kingdom (UK) government has experimented with various alcohol control policies in an effort to curb consumption levels and subsequent harms. In 2010, it enacted a ban on “below cost selling,” which decrees that the selling price to consumers could not be lower than the tax payable on the product. A plan to introduce an alternative “minimum unit price” policy, under which the minimum selling price increases proportionally to the alcoholic content in the drink, was introduced in 2012 but was withdrawn in 2013. The purpose of this study was to estimate the impact of these two alcohol control policies on consumption levels and health harms.

The modeling analyses revealed that a minimum unit price policy would have a significantly greater impact on proportion of alcoholic units affected than a below cost selling ban. In particular, minimum unit price was estimated to reduce consumption levels with a 45-fold greater effectiveness than the below cost selling ban. Furthermore, the minimum unit price policy was also more effective for health harms reduction, demonstrated a 40-50 times greater effect in terms of reducing deaths and hospital admissions; an effect likely due it impacting a greater fraction of the market to a greater extent.

This study was well designed in that it investigated a large population of various ages, consumption levels, and incomes. However, it relied on baseline date from self-report surveys, which are subject to under-reporting of alcohol consumption and purchasing. Also, the modeling analyses did not account for macroeconomic factors affecting alcohol affordability or other policy interventions occurring simultaneously. Finally, while the Sheffield Alcohol Policy Model has been created through thorough literature review, it may actually underestimate the effect of minimum unit pricing if results from implementation in British Columbia are generalizable. Overall, this study suggests that the previously enacted minimum unit price policy would be more effective for reducing alcohol consumption and health harms than current UK alcohol policies.

Click to read the study, published today in the BMJ

Click to read an accompanying editorial in the BMJ

Relevant Reading: Effects of beverage alcohol price and tax levels on drinking

In-Depth [modeling study]: This study utilized a modified version of the Sheffield Alcohol Policy Model (version 2.5) applied to over 11,000 people aged 16 and older in England to estimate the impact of a below cost selling ban and the minimum unit price policy on alcohol consumption levels and health harms. The below cost selling ban was shown to impact only 0.7% of alcohol units, whereas a minimum unit price set at 45 pounds/unit affected 23.3% of all units. This equated to reducing a “harmful” drinker’s mean annual consumption by 3 units compared to 137 units, respectively (harmful drinker defined as mean weekly consumption of >50 units for males and >35 units for females). Moreover, the model estimated that after 10 years of policy implementation, the below cost selling ban would save 14 deaths and 500 hospital admissions compared to 624 deaths and 23,700 hospital admissions with a 45 pound/unit minimum unit price. Thus, the minimum unit price policy was estimated to have a 40-50 fold greater effect in terms of reducing consumption levels and health harms.

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