The 13th World Conference on Tobacco OR Health

Objective: Taiwan had initiated National Smoking Cessation Service (NSCS) since Sep 2002. NSCS reimbursed weekly or biweekly physician counseling (TWD 250/session) with prescription of NRT or bupropion (TWD 250/week) as adjuvant. The study aimed to evaluate the cost-effectiveness of NSCS in different health settings.

Methods: There were fours levels in health care system in Taiwan: medical center (MC), regional hospital (RH), district hospital (DH) and primary care (PC). This study analyzed the data retrieved from National Health Insurance and NSCS in Taiwan. The researchers calculated the average cost of subjects reimbursed by NSCS in different settings. Telephone contacts were made to subjects randomly selected from different settings to record their 6-month abstinent rates. Then, the study estimated the average cost for treating a motivated smoker successfully quit 6 months later in NSCS.

Results: Between Sep 2002 and Mar 2005, 65,360 subjects received cessation treatment in NSCS, including 5,380(8.23%) in MC, 10,757(16.46%) in RH, 10,713(16.39%) in DH, and 38,510(58.92%) in PC. The average cost was TWD 1,352 for a subject reimbursed by NSCS in MC, TWD 1,189 in RH, TWD 1,255 in DH, and TWD 1,155 in PC. The 6-month point abstinence rate for subjects was 27.34% in MC, 23.17% in RH, 20.49% in DH, and 19.08% in PC. The researchers estimated average cost for a successful quitter was TWD 4,944 in MC, TWD 5,134 in RH, TWD 6,125 in DH and TWD 5,866 in PC. In NSCS, the accessibility and availability of PC overlooked its weakness in abstinence rate and cost-effectiveness.