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Cost-effectiveness of tobacco control policies in Vietnam: the case of personal smoking cessation support.
MedLine Citation:
PMID:  21883602     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:  To examine the cost-effectiveness of personal smoking cessation support in Vietnam. Design, setting and participants:  We followed up the population aged 15 and over in 2006 to model the costs and health gains associated with five interventions: physician brief advice; nicotine replacement therapy (patch and gum); Bupropion; and Varenicline. Threshold analysis was undertaken to determine the price levels of pharmaceuticals for the interventions to be cost-effective. A multi-state life table model was constructed such that the interventions affect the smoking cessation behaviour of the age cohorts, and the resulting smoking prevalence defines their health outcomes. A healthcare perspective was employed. Measurements:  Cost-effectiveness is measured in 2006 Vietnamese Dong (VND) per disability-adjusted life year (DALY) averted. We adopted the WHO thresholds of being "cost-effective" if less than 3 times GDP per capita (VND 34,600,000) and "very cost-effective" if less than GDP per capita (VND 11,500,000). Findings:  The cost-effectiveness result of physician brief advice was VND 1,583,000 per DALY averted (Int. $493), which was "very cost-effective". Varenicline dominated Bupropion and nicotine-replacement therapies, although it did not fall within the range of being "cost-effective" under different scenarios. The threshold analysis revealed that prices of pharmaceuticals must be substantially lower than the levels from other countries if pharmacological therapies are to be cost-effective in Vietnam. Conclusions:  Physician brief advice is a cost-effective intervention and should be included in the priority list of tobacco control policy in Vietnam. Pharmacological therapies are not cost-effective, and so they are not recommended in Vietnam at this time unless pharmaceuticals would be produced locally at substantially lower costs in the future.
Authors:
Hideki Higashi; Jan J Barendregt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-23
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  -     ISSN:  1360-0443     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD 4006, Australia.
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