The available evidence (of low and moderate quality) shows that, when administered vaginally, estriol preparations appear to be safe for women who have risk factors related to systemic estrogen therapy.

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Summary Middle‐income countries are experiencing a significant growth of tobacco consumption‐related diseases, while their health systems lack the financial capacity to face them. Existing studies provide a general economic measurement of the problem but give no detailed evidence on the actual financial needs. The aim of this study was to measure the health care costs and financial consequences of the epidemiological changes related to tobacco consumption. A time‐series analysis for 2000 to 2016 was carried out in a national reference hospital in Mexico. We developed probabilistic models following the Box‐Jenkins methodology to forecast the expected changes in the epidemiologic profile and the health care services required for selected interventions. Health care costs were estimated following the instrumentation methods and validated with consensus technique. Comparing the epidemiological and economic burden in 2017 vs. 2019, there is a 20% to 90% increase in expected cases depending of the disease (p < .001) and a 25% to 93% increase in financial requirements (p < .001). Our data suggest that changes in the number of expected cases during the study period highlight the process of internal competition and add an element of intrinsic competition in the financial management of preventive and curative interventions.

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