Minimum unit pricing on alcohol is associated with reductions in alcohol-related hospitalizations and mortality

1. Mortality attributable to alcohol consumption was reduced by 13.4% while hospitalizations were decreased by 4.1% after implementation of minimum unit pricing on alcoholic beverages.

2. Compared to the control group, the minimum unit pricing group reported fewer numbers of alcoholic liver disease and alcohol-related psychoses.

Evidence Rating Level: 3 (Average)

Study Rundown: Alcohol-related liver disease and mortality is a major cause for concern around the world. In May 2018, Scotland issued legislation that required a minimum of £0.50 per unit in an effort to minimize consumption. However, whether this has impacted long-term consumer health remains unclear. This randomized controlled trial aimed to assess the impact of minimum unit pricing (MUP) legislation on alcohol-related hospitalizations and deaths. The time series analysis followed alcohol consumers in Scotland over 32 months since legislation and used data from England to serve as the control group. According to study results, MUP legislation significantly decreased the number of alcohol-related hospitalizations and deaths in Scotland. Although this study was well-done, the control group was from England, as opposed to Scotland, which could affect the validity of data based on patient demographics.

Click to read the study in The Lancet

Relevant Reading: Alcohol Abstinence in Drinkers with Atrial Fibrillation

In-depth [case-control study]: This analysis time series ran from May 1, 2018, to Dec 31, 2020, across multiple hospitals in Scotland and the United Kingdom. The time frame prior to legislation implementation occurred between Jan 1, 2012, to April 30, 2018. Included were patients ≥ 16 years old with known alcohol consumption. The primary endpoint of mortality wholly attributable to alcohol consumption was reduced (13.4%, 95% confidence interval [CI] -18.4 to -8.3, p=0.0004) following MUP introduction in Scotland. Specifically, a substantial reduction was seen in deaths due to alcoholic liver disease (-11.7%, 95% CI -16.7 to 6.4, p<0.01) and alcohol dependence syndrome (-23.0%, 95% CI -36.9 to -6.0, p<0.01). A similar trend was noted for alcohol-related hospitalizations which decreased by 4.1% (95% CI -8.3 to 0.3, p=0.064). MUP legislation was also associated with a reduction in alcoholic liver disease (-9.8%, 95% CI -17.5 to -1.3, p=0.023) and psychoses (-7.2%, 95% CI -12.9 to -1.1, p=0.019). Overall, findings from this study suggest that MUP legislation was associated with a strong reduction in alcohol-related hospitalizations and mortality.

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