An economic analysis of tobacco control policies in Turkey

To evaluate the costs and benefits of various anti-smoking policy alternatives including taxation and four cessation programs, accounting for the demographic projections in 2011-2050 in Turkey. Demographic projections are combined with incidence and mortality rates of four major cigarette related diseases, price elasticity of cigarette demand and unit costs of nonprice measures to reduce demand in order to estimate the net present discounted values of policy alternatives. Among policy alternatives that yield the same amount of cigarette consumption, cessation programs yield lower costs to households and the society at large than taxation, while taxation is preferred by the public sector. Net benefit to the public sector as a function of the tax rate is a single-peaked Laffer curve. The public sector can obtain the highest net benefit if it raises the special consumption tax rate from its current level by nearly 9 percentage points. Although intervention programs emerge as the preferred anti-smoking alternatives, more research is needed on estimating the cost-effectiveness and social desirability of taxation and intervention programs in Turkey.

An economic analysis of tobacco control policies in Turkey

To evaluate the costs and benefits of various anti-smoking policy alternatives including taxation and four cessation programs, accounting for the demographic projections in 2011-2050 in Turkey. Demographic projections are combined with incidence and mortality rates of four major cigarette related diseases, price elasticity of cigarette demand and unit costs of nonprice measures to reduce demand in order to estimate the net present discounted values of policy alternatives. Among policy alternatives that yield the same amount of cigarette consumption, cessation programs yield lower costs to households and the society at large than taxation, while taxation is preferred by the public sector. Net benefit to the public sector as a function of the tax rate is a single-peaked Laffer curve. The public sector can obtain the highest net benefit if it raises the special consumption tax rate from its current level by nearly 9 percentage points. Although intervention programs emerge as the preferred anti-smoking alternatives, more research is needed on estimating the cost-effectiveness and social desirability of taxation and intervention programs in Turkey

Indirect costs of adult pneumococcal disease and the productivity-based rate of return to the 13-valent pneumococcal conjugate vaccine for adults in Turkey

Productivity benefits of health technologies are ignored in typical economic evaluations from a health payer’s perspective, risking undervaluation. We conduct a productivity-based cost-benefit analysis from a societal perspective and estimate indirect costs of adult pneumococcal disease, vaccination benefits from the adult 13-valent pneumococcal conjugate vaccine (PCV13 Adult), and rates of return to PCV13 Adult for a range of hypothetical vaccination costs. Our context is Turkey’s funding PCV13 for the elderly and for non-elderly adults with select comorbidities within the Ministry of Health’s National Immunization Program. We use a Markov model with one-year cycles. Indirect costs from death or disability equal the expected present discounted value of lifetime losses in the infected individual’s paid and unpaid work and in caregivers’ paid work. Vaccination benefits comprise averted indirect costs. Rates of return equal vaccination benefits divided by vaccination costs, minus one. Input parameters are from public data sources. We model comorbidities’ effects by scalar multiplication of the parameters of the general population. Indirect costs per treatment episode of inpatient community-acquired pneumonia (CAP), bacteremia, and meningitis - but not for outpatient CAP - approach or exceed Turkish per capita gross domestic product. Vaccination benefits equal $207.02 per vaccination in 2017 US dollars. The rate of return is positive for all hypothetical costs below this. Results are sensitive to herd effects from pediatric vaccination and vaccine efficacy rates. For a wide range of hypothetical vaccination costs, the rate of return compares favorably with those of other global development interventions with well-established strong investment cases