Sex differences in the association between excessive alcohol consumption and healthcare costs: a retrospective cohort study

Excessive alcohol consumption is associated with a wide range of adverse health outcomes, and these associations may differ by sex. It is therefore likely to contribute to increased healthcare costs, with potentially sex-specific patterns; however, this relationship remains understudied. This study investigated the association between excessive alcohol consumption and subsequent healthcare costs and examined whether this association differed by sex in the Japanese population. This retrospective cohort study included 124,334 Japanese workers using health checkup data from fiscal year 2018, and healthcare costs derived from medical claims data in fiscal year 2022. Excessive alcohol consumption was defined as either a daily intake of ≥ 40 g of pure alcohol or episodic intake of ≥ 60 g of pure alcohol on a single occasion. Gamma-generalized linear models with a log-link were used to estimate healthcare cost ratios between individuals with and without excessive alcohol consumption, and sex-stratified analyses were also conducted. Among the participants, 13.0% were classified as excessive alcohol consumers. Individuals with excessive alcohol consumption had 13% higher healthcare costs than those without (95% confidence interval: 9 to 18%), with stronger associations among women (27%) than men (11%). Excessive alcohol consumption was associated with increased healthcare costs, and the association was stronger in women. Promoting appropriate drinking behaviors and implementing early interventions for excessive alcohol consumption may be crucial in preventing health risks and reducing future healthcare expenditures.