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Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain.

Jiménez-Ruiz CA, Solano-Reina S, Signes-Costa J, de Higes-Martinez E, Granda-Orive JI, Lorza-Blasco JJ, Riesco-Miranda JA, Altet-Gomez N, Barrueco M, Oyagüez I, Rejas J, SESEPARAR’s Integrated Tobacco Research Progr - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: In the reimbursement scenario, the savings accounted for a total of €48.0 million, compensating for expenditures on drugs and medical visits (€40.4 million).Accumulated total additional savings in 5 years (€4.3 million) compared with the scenario without reimbursement was shown.Sensitivity analyses supported the results robustness.

View Article: PubMed Central - PubMed

Affiliation: Specialised Tobacco Unit, Community of Madrid, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

ABSTRACT
The aim of the study was to assess the budgetary impact of funding smoking-cessation drugs in COPD patients in Spain. A hybrid model (cohort and Markov) was developed for a 5-year time horizon. Only approved cessation drugs (varenicline, bupropion, and nicotine replacement therapy) were considered. Irrespective of the drug, the model allowed for an initial cessation attempt, and up to three additional attempts in case of failure or smoking relapse during a 5-year period. Drug effectiveness was based on controlled clinical trials. National Health System perspective was applied; therefore, only medical resources were included. The pharmaceutical costs for smoking-cessation drugs, extra medical follow-up as a consequence of public reimbursement, and annual savings for health costs avoided due to stopping smoking were considered. The model estimated that 17,756 COPD patients would stop smoking if public funding was available, compared with 1,303 without reimbursement. In the reimbursement scenario, the savings accounted for a total of €48.0 million, compensating for expenditures on drugs and medical visits (€40.4 million). Accumulated total additional savings in 5 years (€4.3 million) compared with the scenario without reimbursement was shown. Sensitivity analyses supported the results robustness. Funding smoking-cessation drugs in COPD patients seems to be an efficient option and a National Health System drug reimbursement scheme would represent a cost-saving policy in Spain.

No MeSH data available.


Related in: MedlinePlus

Results of the budget impact for the sensitivity analysis.Notes: The values (in millions of €) of the different scenarios show the impact of the current funded scenario compared with the current unfunded scenario. BIA, budget-impact analysis. The values (in millions of €) of the different scenarios show the impact of this scenario on the current unfunded scenario after discarding the value observed in the current scenario.Abbreviation: COPD, chronic obstructive pulmonary disease.
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f2-copd-10-2027: Results of the budget impact for the sensitivity analysis.Notes: The values (in millions of €) of the different scenarios show the impact of the current funded scenario compared with the current unfunded scenario. BIA, budget-impact analysis. The values (in millions of €) of the different scenarios show the impact of this scenario on the current unfunded scenario after discarding the value observed in the current scenario.Abbreviation: COPD, chronic obstructive pulmonary disease.

Mentions: In the sensitivity analysis, the efficacy of the smoking-cessation therapies was observed to be the parameter with the greatest influence on the results (Figure 2). In the analysis where the efficacy observed in addictive behavior units was applied, the accumulated impact during the 5-year period for the funded scenario, compared with the unfunded scenario, reached a maximum value of €89,880,000 in savings for the NHS. By contrast, when the value below the 95% confidence interval of the economic benefits associated with smoking cessation is considered, an accumulated impact over 5 years would amount to €18,371,000. The tornado chart shown in Figure 3 gives the results of the accumulated impact over the 5 years derived from modifying the parameters used in the sensitivity analyses.


Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain.

Jiménez-Ruiz CA, Solano-Reina S, Signes-Costa J, de Higes-Martinez E, Granda-Orive JI, Lorza-Blasco JJ, Riesco-Miranda JA, Altet-Gomez N, Barrueco M, Oyagüez I, Rejas J, SESEPARAR’s Integrated Tobacco Research Progr - Int J Chron Obstruct Pulmon Dis (2015)

Results of the budget impact for the sensitivity analysis.Notes: The values (in millions of €) of the different scenarios show the impact of the current funded scenario compared with the current unfunded scenario. BIA, budget-impact analysis. The values (in millions of €) of the different scenarios show the impact of this scenario on the current unfunded scenario after discarding the value observed in the current scenario.Abbreviation: COPD, chronic obstructive pulmonary disease.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590338&req=5

f2-copd-10-2027: Results of the budget impact for the sensitivity analysis.Notes: The values (in millions of €) of the different scenarios show the impact of the current funded scenario compared with the current unfunded scenario. BIA, budget-impact analysis. The values (in millions of €) of the different scenarios show the impact of this scenario on the current unfunded scenario after discarding the value observed in the current scenario.Abbreviation: COPD, chronic obstructive pulmonary disease.
Mentions: In the sensitivity analysis, the efficacy of the smoking-cessation therapies was observed to be the parameter with the greatest influence on the results (Figure 2). In the analysis where the efficacy observed in addictive behavior units was applied, the accumulated impact during the 5-year period for the funded scenario, compared with the unfunded scenario, reached a maximum value of €89,880,000 in savings for the NHS. By contrast, when the value below the 95% confidence interval of the economic benefits associated with smoking cessation is considered, an accumulated impact over 5 years would amount to €18,371,000. The tornado chart shown in Figure 3 gives the results of the accumulated impact over the 5 years derived from modifying the parameters used in the sensitivity analyses.

Bottom Line: In the reimbursement scenario, the savings accounted for a total of €48.0 million, compensating for expenditures on drugs and medical visits (€40.4 million).Accumulated total additional savings in 5 years (€4.3 million) compared with the scenario without reimbursement was shown.Sensitivity analyses supported the results robustness.

View Article: PubMed Central - PubMed

Affiliation: Specialised Tobacco Unit, Community of Madrid, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

ABSTRACT
The aim of the study was to assess the budgetary impact of funding smoking-cessation drugs in COPD patients in Spain. A hybrid model (cohort and Markov) was developed for a 5-year time horizon. Only approved cessation drugs (varenicline, bupropion, and nicotine replacement therapy) were considered. Irrespective of the drug, the model allowed for an initial cessation attempt, and up to three additional attempts in case of failure or smoking relapse during a 5-year period. Drug effectiveness was based on controlled clinical trials. National Health System perspective was applied; therefore, only medical resources were included. The pharmaceutical costs for smoking-cessation drugs, extra medical follow-up as a consequence of public reimbursement, and annual savings for health costs avoided due to stopping smoking were considered. The model estimated that 17,756 COPD patients would stop smoking if public funding was available, compared with 1,303 without reimbursement. In the reimbursement scenario, the savings accounted for a total of €48.0 million, compensating for expenditures on drugs and medical visits (€40.4 million). Accumulated total additional savings in 5 years (€4.3 million) compared with the scenario without reimbursement was shown. Sensitivity analyses supported the results robustness. Funding smoking-cessation drugs in COPD patients seems to be an efficient option and a National Health System drug reimbursement scheme would represent a cost-saving policy in Spain.

No MeSH data available.


Related in: MedlinePlus