Working with our smoker patients in primary care. Analysis of cost-effectiveness

The aim of this work is to realize an economic evaluation of the smoking interventions in Primary Care (PC). Cost-Effectiveness Analysis comparing two intervention strategies; intensive and brief. Patients in a general practitioner's list in a peri-urban Health Centre. All the medical histories labelled as smokers; 235 and 37 in the group of brief and intensive intervention respectively. The brief intervention (BI) was made in the context of consultation for another purpose (1-5 minutes). The intensive intervention (II) was exclusively for smoking consultation (10-15 minutes). The effectiveness data are obtained by the evaluation of intervention for smokers, in a general practitioner's list, after 6 years. We employ direct sanitary costs. We exclude drugs, non- sanitary and indirect costs. We apply the valuation of incremental cost-effectiveness ratio (ICER) of the brief interventions, intensive and total (brief + intensive) to compare not taking part with each type of intervention and II with regard to BI and probabilistic analysis to treat the uncertainty. The total cost per abstinent patient was 406,74 €: 129,83 € for BI and 1.034,99 € for I.I. ICER Total intervention = €498, 87/patient who stops smoking. ICER BI = €235, 32/patient who stops smoking. ICER II = €1.232, 85/patient who stops smoking. ICER II/BI = €7.772,25/patient who stops smoking. Smoking interventions in PC are efficient. A proposal for smoking intervention in PC from an effective cost perspective could be an BI for smokers and an II on those who find more difficult to leave the habit.