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. 2025 Oct;120(10):2094-2104.
doi: 10.1111/add.70083. Epub 2025 May 6.

A return on investment analysis for the 2017 increase in alcohol excise taxation in Lithuania

Jürgen Rehm  1   2   3   4   5   6   7   8 , Pol Rovira  8 , Ahmed S Hassan  1   4 , Claire de Oliveira  1   2   4 , Shannon Lange  1   2   5   6 , Mark J Thompson  9   10 , Ilona Tamutienė  9 , Vaida Liutkutė-Gumarov  9 , Lukas Galkus  9 , Mindaugas Štelemėkas  9   11
Affiliations

A return on investment analysis for the 2017 increase in alcohol excise taxation in Lithuania

Jürgen Rehm et al. Addiction. 2025 Oct.

Abstract

Aims: To conduct a return on investment analysis of Lithuania's 2017 increase in alcohol excise taxation of 112% for beer, 111% for wine, and 23% for ethyl alcohol (spirits), resulting in a marked decrease in alcohol affordability.

Methods: Economic analyses based on costs of the increased taxation and economic benefits derived from a societal perspective. Costs were measured according to World Health Organization standards, based on Lithuanian public data. Benefits were derived from the difference of direct (healthcare, childcare, legal) and indirect costs between 12 months pre- and post-enactment of the policy. All costs and benefits were expressed in 2023 Euros (€).

Results: Overall, there were net benefits from reductions in productivity losses and increases in tax revenue. Tax revenue increased by 20%, or more than €100 million, in the first-year post enactment, and productivity losses decreased over the same time period by about €35.3 million (95% confidence interval [CI]: -51.9 to -17.1; proportionally -7%; 95% CI: -11.0% to -4.0%), the latter based on marked reductions in premature mortality in all alcohol-attributable causes of death. In addition, healthcare costs decreased by about €3.8 million (95% CI: -8.4 to +0.1; proportionally -5%; 95% CI: -11.0% to +0.1%). On the other hand, childcare and legal costs increased compared with the year before, by €5.3 million (no 95% CI possible; proportionally: +7%) and €4.6 million (95% CI: +0.2 to +8.0; proportionally +5%; 95% CI: +0.3 to +8.7%), respectively. The final return on investment was 420 to 1, i.e. for each Euro invested, the return was €420. In the sensitivity analyses, the return on investment varied between 292 to 1 and 530 to 1, meaning that all assumptions resulted in a very positive return.

Conclusions: The increase in excise taxation for alcohol on March 1, 2017 in Lithuania created a large return on investment and reduced alcohol-attributable mortality and hospitalizations.

Keywords: Lithuania; alcohol; excise taxation; mortality; return on investment; tax revenue.

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Conflict of interest statement

None.

References

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