Effect of Smoking Status on Healthcare Costs and Resource Utilization in Patients with Type 2 Diabetes in Routine Clinical Practice: A Retrospective Nested Case-Control Economic Study

Sicras‐Mainar, Antoni; Rejas‐Gutiérrez, Javier; Navarro‐Artieda, Ruth; Ibáñez-Nolla, Jordi

doi:10.1159/000355171

Cited by 16 publications

(17 citation statements)

References 40 publications

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“…These annual average cost savings were different depending on the population analyzed: €651 for t2-DM, €200 for patients with CVD and €779 (40- 11 €1,345 (+70 years) for COPD [20][21][22] ( table 1 ). This is then added up over the complete 5-year follow-up period for the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, on an average, more than two-thirds of the estimated cost-savings would be due to reducing the drug use and number of medical visits to treat the underlying health condition of the smokers who would quit smoking [20][21][22] . For example, approximately 65% of the costs avoided as a consequence of quitting smoking in COPD subjects correspond to reducing the use of bronchodilators currently funded by the SNHS as reported in the study of smokingcessation cost-saving in COPD subjects from SicrasMainar et al [20] In diabetics, however, most of the savings is reducing the burden from medical visits [21] .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, smoking cessation has been shown to be associated with substantial savings for the SNHS, particularly in the publically funded healthcare costs for these health conditions, with an average annual per patient saving varying between €1,345 for COPD patients to €200 in CVD patients per year [20][21][22] . However, smoking-cessation treatments are not funded in those subjects who would like to quit smoking.…”

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confidence: 99%

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Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective

Cedillo¹,

Sicras‐Mainar²,

Jiménez-Ruíz³

et al. 2016

Eur Addict Res

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Aims: The study aimed to assess the budgetary impact (BI) of reimbursing varenicline in patients with chronic obstructive pulmonary disease (COPD), type-2 diabetes mellitus (t2-DM) or cardiovascular diseases (CVD). Methods: The BI was estimated comparing the current non-reimbursed scenario versus a projected reimbursed scenario using the Spanish National Health System (SNHS) perspective. A hybrid model was developed using epidemiological data and Markov chains to estimate smoking cessation rates with varenicline during a 5-year horizon. Costs of cessation were considered in the reimbursement scenario only. Efficacy, expressed as a 1-year continuous abstinence rate, was derived from clinical trials. Cost savings due to smoking cessation were extracted from local cost-of-illness studies. Results are shown as incremental cost savings. Univariate sensitivity analysis was also applied. Results: A total of 68,684 patients stopped smoking in the reimbursed scenario compared with 15,208 without reimbursement. In the reimbursed scenario, total savings accounted for €36.3 million, showing 14.6 million accumulated additional savings compared with the scenario without reimbursement. Sensitivity analyses showed results to be robust with monetary savings starting in the third year of modeling. Conclusion: Reimbursement of varenicline in smoking cessation is a cost-effective health policy in the SNHS in COPD, t2-DM or CVD, and could produce cost savings starting in the third year of implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective

Cedillo¹,

Sicras‐Mainar²,

Jiménez-Ruíz³

et al. 2016

Eur Addict Res

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“…Based on the findings of Sicras-Mainar [21] in a cohort of Spanish diabetic patients, a cost of € 3,637.6 and € 2,864.0 is estimated for the smoking and the no longer smoking population, respectively, with an annual saving per cessation of € 774.0. The annual cost per CVD patient was estimated based on the studies conducted by Fattore et al [22] on stroke and Roggeri et al [23] on myocardial infarction and angina, which report values of € 11,747.0 and € 11,464.0, respectively.…”

Section: Methodsmentioning

confidence: 99%

Varenicline treatment for smoking cessation in high risk patients: a budget impact analysis

Spandonaro

Mancusi²,

Polistena

2017

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INTRODUCTION: The promotion of smoking cessation is a worldwide Public Health priority. OBJECTIVE: To estimate the budget impact on the Italian National Health Service (NHS) of the access to reimbursement of varenicline for the treatment of high risk patients with bronchopulmonary, diabetic and cardiovascular diseases. METHODS: A closed-group Markov model was developed in order to compare the costs incurred by the NHS to promote smoking cessation with cessation-related savings, using an alternative scenario in which aids to cessation are not reimbursed by the NHS. The analysis was conducted over a 5-year time horizon, in the perspective of the Italian NHS. Efficacy was expressed in terms of smoke abstinence for at least one year, and data was derived from clinical trials; the savings associated with smoking cessation were derived from cost-of-illness studies. RESULTS: The results show how costs would concentrate in the first year: they are estimated at € 200.6 million, of which € 162.4 million for drug therapy and € 38.2 million for counseling. Average annual savings over the first five years are estimated at € 77.7 million, with a cumulative net impact at 5 years of € -188.0 million (cost-saving). The analysis appears to be robust: sensitivity analyses show that the covering of initial costs occurs in any case between the third and fourth year, and that the treatment remains cost-saving at 5 years. CONCLUSIONS: The financial impact on the Italian NHS of the reimbursement of varenicline for the treatment of high risk smoking population would be a sustainable healthcare policy, resulting in cost savings starting from the fourth year.

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“…Economic studies have been conducted on the efficiency of smoking cessation programmes. However, there are no data on the efficiency of health programmes or policies aimed at smoking cessation before planned surgery with hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Cost–benefit analysis of funding smoking cessation before surgery

Jiménez-Ruíz

Martín

Alsina-Restoy

et al. 2020

British Journal of Surgery

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Background Smoking at the time of surgery is associated with postoperative complications. Quitting smoking before surgery is linked to fewer complications during the hospital stay. This work analysed whether a smoking cessation intervention before surgery is economically worthwhile when funded by the National Health System (NHS) in Spain. Methods The economic analysis considered costs and benefits of the intervention to the NHS for the year 2016. The population who would benefit comprised adult smokers who were ready to quit and for whom surgery requiring admission to hospital was planned. The intervention, a combination of medical counselling and use of a smoking cessation drug which should occur 12 weeks before surgery, considered one attempt only to quit smoking. Benefits were costs avoided by averting postoperative complications if cessation was successful. The analysis compared the net economic outcome (benefit minus cost of intervention) and the return on investment, for intervention funded by the NHS versus the current situation without funding. Results Smoking cessation increased by 21·7 per cent with funding; the rate was 32·5 per cent when funded versus 10·7 per cent without funding, producing 9611 extra quitters. The cost per averted smoker was €1753 with a benefit of €503, achieving a net economic benefit of €4·8 million per year. Given the annual cost of the intervention (€17·4 million, of which €5·6 million (32·5 per cent) represents drugs), the return on investment was 28·7 per cent annually, equivalent to €1·29 per €1 of investment. Conclusion From the perspective of the Spanish NHS, the benefit of funding smoking cessation before surgery, in terms of healthcare cost savings, appears to greatly outweigh the costs.

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Effect of Smoking Status on Healthcare Costs and Resource Utilization in Patients with Type 2 Diabetes in Routine Clinical Practice: A Retrospective Nested Case-Control Economic Study

Cited by 16 publications

References 40 publications

Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective

Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective

Varenicline treatment for smoking cessation in high risk patients: a budget impact analysis

Cost–benefit analysis of funding smoking cessation before surgery

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