A microsimulation economic model to evaluate the disease burden associated with smoking in Argentina

PICHON-RIVIERE A,; AUGUSTOVSKI, F; COLANTONIO, LISANDRO; BARDACH, ARIEL; RUBINSTEIN, A

Congreso; ISPOR 12th Annual European Congress Paris France.; 2009

ISPOR

OBJECTIVES: To perform a comprehensive evaluation of tobacco-related disease burden in Argentina, including both its health effects and its economic impact METHODS: A first order Monte Carlo, or probabilistic microsimulation of individual patients was built, incorporating the natural history, costs and quality of life impact of all the tobacco-related adult diseases: coronary and non-coronary heart diseases, cerebrovascular disease, COPD, pneumonia/influenza, lung cancer as well as 9 other neoplasms. Systematic searches were performed in bibliographic database, grey literature and experts. RESULTS: The model showed adequate internal validity, with all simulated events rates falling within +/-10% of the source publications. R2 between predicted and observed values ranged from 0.758 to 0.999. Third order validation showed an excellent correlation between published data and model results. Health conditions related to smoking were responsible of 129,630 annual deaths in Argentina, 25% of them (32,167) attributable to tobacco. The annual costs for the country were of about $9.5 billion pesos (Argentinean pesos, 2006), smoking being responsible for 34%. Male smokers lost 5.5 years of life expectancy as compared to their non-smoking counterparts. A total of 721,285 total annual DALYs were attributable to tobacco use, among which the main conditions were cardiovascular disease, lung cancer and COPD. Premature deaths accounted for three quarters of DALYs. CONCLUSIONS: These results confirm the local relevance of smoking as an important health an economic burden in our country. They may be of great importance as strategic inputs for decision-makers, facing the ratification of the Framework Convention on Tobacco Control goals.