Abstract
Aims: To examine the cost-effectiveness of personal smoking cessation support in Vietnam.
Design, setting and participants: We followed up the population aged 15 and over in 2006 to model the costs and health gains associated with five interventions: physician brief advice; nicotine replacement therapy (patch and gum); Bupropion; and Varenicline. Threshold analysis was undertaken to determine the price levels of pharmaceuticals for the interventions to be cost-effective. A multi-state life table model was constructed such that the interventions affect the smoking cessation behaviour of the age cohorts, and the resulting smoking prevalence defines their health outcomes. A healthcare perspective was employed.
Measurements: Cost-effectiveness is measured in 2006 Vietnamese Dong (VND) per disability-adjusted life year (DALY) averted. We adopted the WHO thresholds of being “cost-effective” if less than 3 times GDP per capita (VND 34,600,000) and “very cost-effective” if less than GDP per capita (VND 11,500,000).
Findings: The cost-effectiveness result of physician brief advice was VND 1,583,000 per DALY averted (Int. $493), which was “very cost-effective”. Varenicline dominated Bupropion and nicotine-replacement therapies, although it did not fall within the range of being “cost-effective” under different scenarios. The threshold analysis revealed that prices of pharmaceuticals must be substantially lower than the levels from other countries if pharmacological therapies are to be cost-effective in Vietnam.
Conclusions: Physician brief advice is a cost-effective intervention and should be included in the priority list of tobacco control policy in Vietnam. Pharmacological therapies are not cost-effective, and so they are not recommended in Vietnam at this time unless pharmaceuticals would be produced locally at substantially lower costs in the future.