Economic Implications of Reduced Binge Drinking Among the Military Health System’s TRICARE Prime Plan Beneficiaries

Abstract

This study examines the economic burden of alcohol misuse to the Department of Defense (DoD) and the benefits of reduced binge drinking among beneficiaries in the DoD's TRICARE Prime plan. Data analyzed include administrative records for approximately 3 million beneficiaries age 18 to 64, DoD's Survey of Health Related Behaviors Among Military Personnel, and the National Survey on Drug Use and Health. Alcohol misuse among Prime beneficiaries cost the DoD an estimated $1.2 billion in 2006--$425 million in higher medical costs and $745 million in reduced readiness and misconduct charges. Potential annual gross benefits to the DoD of reduced binge drinking are simulated for three scenarios: (1) implementing a comprehensive alcohol screening with referral to brief intervention or treatment by primary care ($87 million/$129 million in short/long-term benefits); (2) increasing the price of alcoholic beverages on military installations by 20% ($75 million/$115 million); and (3) implementing a Web-based education program ($81 million/$123 million).

Risk factors for relapse to problem drinking among current and former US military personnel: A prospective study of the Millennium Cohort

“…However, problem drinking may be particularly costly among military personnel via decreased performance (Frone, 2006;Harwood et al, 2009;Lamond and Dawson, 1999;O'Brien and Lyons, 2000), adverse physical health outcomes (Harris et al, 2009;Williams et al, 2012), comorbid mental health disorders (Milliken et al, 2007), and risk of suicide (LeardMann et al, 2013). Remitting and relapsing problem drinking may be particularly risky among military personnel because it may reflect disordered drinking, which is often difficult to control and change once developed (National Center on Addiction and Substance Abuse, 2012).…”

“…Problem drinking may be particularly costly in this population due to associated decreased work performance (Blume et al, 2010;Frone, 2006;Harwood et al, 2009), impaired athletic performance (O'Brien and Lyons, 2000), increased risk of injury (Harris et al, 2009;Williams et al, 2012) and comorbid mental health disorders (Bray et al, 2010;LeardMann et al, 2013),and multiple other adverse health outcomes including sleep deprivation and fatigue (Lamond and Dawson, 1999;Roth and Roehrs, 1996) that may lead to performance impairment (Harwood et al, 2009;Institute of Medicine, 2012). The costs of alcohol use to the Department of Defense (DoD) were recently estimated at $425 million per year (Dall et al, 2007;Institute of Medicine, 2012).…”

“…Alcohol use is the third-greatest contributor to morbidity and mortality in the United States (Mokdad et al, 2004) and comes at enormous cost to society (Harwood et al, 1998(Harwood et al, , 2009. While many people drink alcohol at healthy levels, approximately 9% drink at levels that result in the development of problems (e.g., familial or legal problems; Grant et al, 2004).…”

2015 Department of Defense Health Related Behaviors Survey (HRBS)

“…It can lead to risky sexual activity, accidents, violence, and other serious consequences. Alcohol misuse is linked to a variety of adverse outcomes in the military and is a costly problem for DoD (Dall et al, 2007;Harwood et al, 2009).…”

Effect of the Alcohol Misconduct Prevention Program (AMPP) in Air Force Technical Training

“…6 In 2006, alcohol misuse among TRICARE Prime beneficiaries cost the Department of Defense (DoD) an estimated $1.2B; $425M in higher medical costs and $745M in reduced readiness and misconduct charges. 7 Multiple approaches to reducing alcohol misuse and problem drinking exist. Meta-analyses have demonstrated that policies regulating the environment in which alcohol is marketed, particularly its price and availability, and enforced legislative measures to reduce impaired driving are effective in reducing alcohol-related harm.…”