title: Cost-effectiveness of tobacco control policies in Vietnam: the case of personal smoking cessation support.
abstract: OBJECTIVE
  To examine the cost-effectiveness of personal smoking cessation support in Vietnam.
  
  
  METHODS
  We followed-up the population aged 15 years 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 health-care perspective was employed.
  
  
  METHODS
  Cost-effectiveness is measured in 2006 Vietnamese Dong (VND) per disability-adjusted life year (DALY) averted. We adopted the World Health Organization thresholds of being 'cost-effective' if less than three times gross domestic product (GDP) per capita (VND 34,600,000) and 'very cost-effective' if less than GDP per capita (VND 11,500,000).
  
  
  RESULTS
  The cost-effectiveness result of physician brief advice was VND 1,742,000 per DALY averted (international dollars 543), 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 could be produced locally at substantially lower costs in the future.
authors: The University of Queensland, School of Population Health, Herston, QLD 4006, Australia. h.higashi@uqconnect.edu.au
authors: Hideki
authors: H
authors: Higashi
authors: Jan J
authors: JJ
authors: Barendregt
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000191:economics / Q000627:therapeutic use; D001552:Benzazepines / Q000191:economics / Q000627:therapeutic use; D016642:Bupropion / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D006291:Health Policy / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000191:economics / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011810:Quinoxalines / Q000191:economics / Q000627:therapeutic use; D012907:Smoking / Q000191:economics; D016540:Smoking Cessation / Q000191:economics*; D000074606:Smoking Prevention; D012944:Social Support; D061485:Tobacco Use Cessation Devices / Q000191:economics*; D000068580:Varenicline; D014744:Vietnam; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D016642:Bupropion; D000068580:Varenicline