COST-BENEFIT ANALYSIS OF A SMOKING CESSATION PROGRAM FUNDED BY THE SPANISH NATIONAL SYSTEM IN PRE-OPERATIVE PATIENTS
Author(s)
Jiménez CA1, Martín V2, Rejas J3
1Servicio Madrileño de Salud, Madrid, Spain, 2Universidad Carlos III, Getafe (Madrid), Spain, 3Pfizer SLU, Alcobendas, Spain
OBJECTIVES: Despite measures to stop smoking leading to a drop in its prevalence, morbi-mortality due to tobacco use is still high. Patients smoking at the time of surgery are at elevated risk of postoperative complications. Thus, decreasing smoking prevalence is a primary objective for healthcare professionals and authorities yet. The aim was to analyze the efficiency of a smoking-cessation program in pre-operative patients funded by the National Health System (NHS) in Spain. METHODS: A cost-benefit analysis was performed from the NHS perspective in year 2016 in a smoking annual any-type surgery cohort ready to quit smoking. This cohort was identified from the year-2014 national annual hospital discharge report and characterized using published inputs from national health survey. Included costs corresponded to the implementation of the smoking-cessation program, and were medical counselling/follow up and quitting smoking drugs (varenicline, bupropion and nicotine-replacement-therapy), which are not funded currently. Benefits were considered healthcare costs avoided due to postoperative complications averted as a consequence of smoking cessation, at least, 8-weeks before surgery. Net cost-benefit, return-of-investment (ROI) and benefit per averted smoker were computed. RESULTS: Assuming a composite effectiveness of 21%, the funded program would produce 8,368 extra quitters and would achieve a total net cost-benefit of €3.1 million per year of implementation. Given the annual total cost of the program (€12.6 million of which €4.4 correspond to drugs), the ROI was +24% annually (€1.24 of benefit per €1 of investment). The average cost per additional averted smoker was €1,511 with a net healthcare benefit of €366 per patient. Univariate sensitivity analyses were robust and sensitive to the incremental use of varenicline (better cost-benefit). CONCLUSIONS: From the NHS perspective in Spain, the benefit of funding smoking-cessation in pre-operative patients, in terms of healthcare costs savings are far greater than the costs, with a wealthy return-of-investment.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PRS31
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Respiratory-Related Disorders