Health and Economic Burden of Tobacco Use in Seven Latin American Countries: Results from a Microsimulation Health Economic Model

BARDACH A,; CAPORALE J,; AUGUSTOVSKI F,; ANDRÉS PICHON-RIVIERE; ALCARAZ A,; NAVIA MDP,

VALUE IN HEALTH

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Londres; Año: 2013

1098-3015

Objectives: Smoking is the single most preventable cause of disease and death allaround the world. Our objective was to quantify the disease burden associated withsmoking in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico and Peru. Methods:The project began with a survey to health Decision Makers (DM) to explore countryspecificinformation needs. The development stage involved the harmonization ofa methodology to retrieve local relevant parameters and develop the model structure.A microsimulation HEM was built considering the availability and quality ofepidemiological data and relevant outcomes were conceived to suit the identifiedinformation needs of DMs . It considers all tobacco-related diseases: heart, cerebrovascularand chronic obstructive pulmonary disease, pneumonia/influenza, lungcancer and nine other neoplasms. A systematic search on effectiveness, local epidemiologyand costs studies was undertaken to populate the model. Calibration andvalidation was performed for each country. Predicted event rates were comparedto the published rates used as model inputs. External validation was undertakenagainst epidemiological studies not used to provide input data. Results: The calibratedmodel showed all simulated event rates falling within ±10% of the sourcesand a high correlation between published data and model results. In these seven LAcountries, tobacco is responsible of 259,126 deaths each year. The diseases attributableto smoking cause a total of 1∙90 million years of life lost due to prematuredeath, 0∙64 million years of life lost due to disability and at least 27 billion dollars(USD dollars 2013) in direct medical costs each year. Conclusions: Tobacco use is responsible for an enormous burden of disease in the region. This evidence-based,internally and externally valid HEM showed to be an adequate tool for the assessmentof the effects of smoking and could be a useful policy-making tool to estimatethe cost-effectiveness of tobacco control interventions.