Estimates of costs for modelling return on investment from smoking cessation interventions

© 2018 The Authors. Background and aims: Modelling return on investment (ROI) from smoking cessation interventions requires estimates of their costs and benefits. This paper describes a standardized method developed to source both economic costs of tobacco smoking and costs of implementing cessation interventions for a Europe-wide ROI model (EQUIPTMOD). Design: Focused search of administrative and published data. A standardized checklist was developed in order to ensure consistency in methods of data collection. . Setting and participants: Adult population (15+ years) in Hungary, Netherlands, Germany, Spain and England. For passive smoking related costs, child population (0-15 years) was also included. Measurements: Costs of treating smoking attributable diseases; productivity losses due to smoking attributable absenteeism; and costs of implementing smoking cessation interventions. . Findings: Annual costs (per case) of treating smoking attributable lung cancer were between €5,074 (Hungary) and €52,106 (Germany); coronary heart disease between €1,521 (Spain) and €3,955 (Netherlands); chronic obstructive pulmonary disease between €1,280 (England) and €4,199 (Spain); stroke between €1,829 (Hungary) and €14,880 (Netherlands). Costs (per recipient) of smoking cessation medications were estimated to be: for standard duration of varenicline between €225 (England) and €465 (Hungary); for bupropion between €25 (Hungary) and €220 (Germany). Costs (per recipient) of providing behavioral support were also wide-ranging: one-to-one behavioural support between €34 (Hungary) and €474 (Netherlands); and group-based behavioural support between €12 (Hungary) and €257 (Germany). The costs (per recipient) of delivering brief physician advice were: €24 (England); €9 (Germany); €4 (Hungary); €33 (Netherlands); and €27 (Spain). Conclusions: Costs of treating smoking-attributable diseases as well as the costs of implementing smoking cessation interventions vary substantially across Hungary, Netherlands, Germany, Spain and England. Estimates for the costs of these diseases and interventions can contribute to return on investment estimates in support of national or regional policy decisions

Approximations to the Truth: Comparing Survey and Microsimulation Approaches to Measuring Income for Social Indicators

In this paper, we evaluate income distributions in four European countries (Austria, Italy, Spain and Hungary) using two complementary approaches: a standard approach based on reported incomes in survey data, and a microsimulation approach, where taxes and benefits are simulated. These two approaches may be expected to generate slightly different results, particularly in respect of individuals on lower incomes, because benefit receipts tend to be under-reported in survey data, and over-estimated in microsimulation procedures. However, we find that the two approaches do in fact produce reasonably consistent results, in terms of both inequality measures and poverty rates. To the extent that the results differ, we explore the reasons why these differences arise, and suggest directions for future research, in which each approach may inform improvements in the other. © 2011 Springer Science+Business Media B.V

Screening for Chlamydia trachomatis in asymptomatic women in Hungary

Background. A multicenter survey was carried out in order to determine the prevalence and risk factors for Chlamydia trachomatis infection in the population of asymptomatic: women in Hungary. Results were used to carry out a cost-effectiveness analysis of screening for chlamydial infection in women with asymptomatic genital infections. Methods. The non-amplified nucleic acid hybridization method (PACE 2 Gen-Probe) was used to diagnose C. trachomatis and Bayes' theorem was applied to assess the prevalence of the infection. Multiple logistic regression analysis was performed to differentiate the risk factors for chlamydial infections. Results. According to the test, the prevalence of Chlamydia trachomatis among 1300 pregnant women was 4.5%. The sensitivity and specificity of the test are estimated to be 70% and 99%. respectively. After Bayes' correction, the overall estimated prevalence of chlamydial infection was 5.1%. There were significant differences in proportions of chlamydial infection in different regions, and also in different age groups and different family status groups. The highest rate was for women aged below 20 years: 16.9%. Cost-effectiveness analysis, with associated sensitivity analysis was carried out for women aged below 20 years. Three screening strategies were compared: using the ELISA method, using amplified Gen-Probe method and no screening. The amplified Gen-Probe method was best provided, the infection prevalence exceeded 16.7%, the PID rate exceeded 24% and the probability of tubal infertility in untreated women exceeded 25%. Conclusion. We conclude that screening with amplified Gen-Probe assays (followed by treatment of positive patients) is the preferred screening strategy for young women in Hungary