INVESTIGADORES
RUBINSTEIN Adolfo Luis
artículos
Título:
Development and Validation of a Microsimulation Economic Model to Evaluate the Disease Burden Associated with Smoking and the Cost- Effectiveness of Tobacco Control Interventions in Latin America
Autor/es:
ANDRÉS PICHÓN RIVIERE; F. AUGUSTOVSKI; BARDACH, A; COLANTONIO, L; RUBINSTEIN, A
Revista:
ENERGY
Editorial:
PERGAMON-ELSEVIER SCIENCE LTD
Referencias:
Lugar: Amsterdam; Año: 2011 p. 1 - 10
ISSN:
0360-5442
Resumen:
Objective: To describe the development and validation of a health economic
model (HEM) to address the tobacco disease burden and the
cost-effectiveness of smoking cessation interventions (SCI) in seven
Latin American countries. Methods: The preparatory stage included
the organization of the research network, analysis of availability of
epidemiologic data, and a survey to health decision makers 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. Calibration and validation was
performed using a selected country dataset (Argentina 2005). Predicted
event rates were compared to the published rates used as model inputs.
External validation was undertaken against epidemiologic studies
that were not used to provide input data. Results: Sixty-eight decision
makers were surveyed. A microsimulation HEM was built
considering the availability and quality of epidemiologic data and relevant
outcomes conceived to suit the identified information needs of
decision makers. It considers all tobacco-related diseases (i.e., heart,
cerebrovascular and chronic obstructive pulmonary disease, pneumonia/
influenza, lung cancer, and nine other neoplasms) and can incorporate
individual- and population-level interventions. The calibrated
model showed all simulated event rates falling within 10% of the
sources (-9%?5%). External validation showed a high correlation between
published data and model results. Conclusions: This evidencebased,
internally and externally valid HEM for the assessment of the
effects of smoking and SCIs incorporates a broad spectrum of tobacco
related diseases, SCI, and benefit measures. It could be a useful policymaking
tool to estimate tobacco burden and cost-effectiveness of SCI.
Keywords: cost-effectiveness, cost-utility, disease burden, economic
model, Latin America, Monte Carlo microsimulation, smoking cessation
interventions, tobacco, validation.