Effect of Smoking Status on Costs-of-Illness in Patients with a Depressive Disorder in Spain: An Approximation from the National Health Survey

Abstract

A523smokers of one or more years since quitting smoking and never smokers. HRU and sick leaves accounting for productivity loss were computed on an annualized basis. Multivariate general linear models adjusting for sex, age and number of comorbidities were applied. Results: A total of 1,816 [mean age 62.4+15.4 years (76.9% female)] records were analyzed: 381 smokers, 290 former smokers, and 1,145 from never smokers. Smokers had higher both total and healthcare annual costs (€ 2941 and € 2,283, respectively) than former smokers (€ 2,143 and € 1,740) and never smokers (€ 2,397 and € 1,866), p= 0.061 and p= 0.036: exceed cost of € 798 and € 543 (p= 0.037 and p= 0.029) and € 543 and € 417 (p= 0.105 and p= 0.042), respectively. Medical visits to healthcare professionals accounted for 54% of total annual costs while indirect costs depicted 22%. ConClusions: Subjects with a DD who still smoke are associated with higher HRU and costs from the societal perspective, when compared with both former and never smokers in the Spanish general population. As a consequence, quitting smoking in patients with a DD might be a value-for-money health policy in Spain.

Modelling a budgetary impact analysis for funding drug-based smoking cessation therapies for patients with major depressive disorder in Spain

“…Average cost avoided per patient and per year of smoking cessation 788.00 599.00 [27] SNHS: Spanish National Health System. a Bupropion cost expected to be fully funded by the SNHS with the exception of a 7.5% mandatory rebate that is covered by the manufacturer [38].…”

“…These visits were priced according to local rates and computed for both the SNHS and societal perspectives [39]. The average cost avoided per patient per year of smoking cessation was extracted from ENSE 2013 data which estimated the cost-of-illness in smokers and former smokers with MDD from the societal (direct healthcare costs and indirect work absenteeism costs) perspective [27]. Costs avoided due to smoking cessation were not corrected by years of quitting as the coefficient of correlation either for total costs and healthcare costs as well were poor in both cases after adjusting by sex, age and number of comorbidities; r = 0.091 ( P = 0.126) and r = 0.051 ( P = 0.390) for total costs and healthcare costs, respectively.…”

“…Furthermore, smokers with MDD who had quit smoking were observed to incur substantial monetary savings for the SNHS and society in comparison with smokers in Spain. Savings were predominantly due to significant reductions in the use of antidepressants, healthcare professional visits and a reduction in work absenteeism [27].…”