HEALTH AND ECONOMIC BURDEN OF TOBACCO USE IN SEVEN LATIN AMERICAN COUNTRIES: RESULTS FROM A MICROSIMULATION HEALTH ECONOMIC MODEL (HEM)

PICHON-RIVIERE A,; BARDACH, ARIEL; CAPORALE J; AUGUSTOVSKI, F; ALCARAZ A; NAVÍA MDP; PINTO M; VALLEJOS C; PEÑA TORRES E; REYNALES LM; GALLEGOS V; HUAYNAY L

Conferencia; Ispor 4th Latin America Conference; 2013

OBJECTIVES: Smoking is the single most preventable cause of disease and death all around the world. Our objective was to quantify the disease burden associated with smoking in Argentina, Bolivia, Brazil, Chile, Colombia, Mexico and Peru. METHODS: The project began with a survey to health Decision Makers (DM) to explore country-specific information needs. The development stage involved the harmonization of a methodology to retrieve local relevant parameters and develop the model structure. A microsimulation HEM was built considering the availability and quality of epidemiological data and relevant outcomes were conceived to suit the identified information needs of DMs . It considers all tobacco-related diseases: heart, cerebrovascular and chronic obstructive pulmonary disease, pneumonia/influenza, lung cancer and nine other neoplasms. A systematic search on effectiveness, local epidemiology and costs studies was undertaken to populate the model.  Calibration and validation was performed for each country. Predicted event rates were compared to the published rates used as model inputs. External validation was undertaken against epidemiological studies not used to provide input data. RESULTS: The calibrated model showed all simulated event rates falling within ±10% of the sources and a high correlation between published data and model results. In these seven LA countries, tobacco is responsible of 259,126 deaths each year. The diseases attributable to smoking cause a total of 1∙90 million years of life lost due to premature death,  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 assessment of the effects of smoking and could be a useful policy-making tool to estimate the cost-effectiveness of tobacco control interventions.