The economic burden of alcohol in Belgium: incremental healthcare costs and lost productivity.

Alcohol use is associated with a high burden of disease, resulting in economic consequences. In Belgium, 77% of the population over the age of 15 regularly consume alcohol. Therefore, the objective of this study is to provide updated estimates of the annual healthcare costs and productivity losses among the Belgian population. Data from the 2018 Belgian Health Interview Survey (BHIS) were linked with health insurance claims data. Healthcare costs were calculated on individuals' alcohol use patterns (current, former, abstainer). Lost productivity costs were calculated by multiplying the number of absence days by the national average wage cost per day. Univariate and multivariable regression analysis with negative binomial distribution and log link were performed to evaluate the average healthcare costs and indirect costs in relation to alcohol use, sociodemographic characteristics, and (behavioural) risk factors. Data from 10 829 individuals were available, of which 47.7% were men. A total of 76% subjects indicated that they currently drink alcohol. Compared to abstainers, significantly lower costs were found for current drinkers (€-470; P = .002). When looking at former drinkers, a significantly higher cost (€889; P = .02) was found compared with individuals who indicated that they never used alcohol. Taking into account that 7% of the Belgian population were former drinkers in 2018, the national costs for former drinkers equates to €711 288 900. Results of our study show that alcohol use has a large economic impact on the Belgian society. Especially former drinkers have a substantial impact on direct medical costs.