The budget impact analysis of nicotine replacement therapy among patients who smoke tobacco and have mental illness in South Africa and the implications.
Study Goal
The researchers aimed to assess the economic feasibility of implementing a Nicotine Replacement Therapy (NRT)-based smoking cessation program in a psychiatric hospital in South Africa.
Results Summary
The study found that implementing a 3-month NRT program for 214 patients would cost R1,478,915.42, requiring an additional 0.15% of the hospital budget and 6.09% of the pharmacy budget. The results highlight the need for careful budget allocation to ensure program sustainability.
Population
Primarily black, male, unemployed patients diagnosed with schizophrenia who smoked lightly.
Effective Dosage
Not specified
Duration
3 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Nicotine Replacement Therapy (NRT)-based smoking cessation program | increase | budget | 214 patients in a psychiatric hospital | R1 478 915.42 | would result in an expenditure of | #1 |
Nicotine Replacement Therapy (NRT)-based smoking cessation program | increase | total hospital budget | hospital | 0.15% (±0.0095) | would require an additional | #2 |
Nicotine Replacement Therapy (NRT)-based smoking cessation program | increase | hospital pharmacy budget | hospital | 6.09% (±0.31) | would require an additional | #3 |
Nicotine Replacement Therapy (NRT) | increase | overall health outcomes | patients with mental illnesses | - | is crucial for improving | #4 |
BACKGROUND: Tobacco use is the world's leading preventable cause of death, with the highest burden in low and middle-income countries (LMICs). Those who have mental illness are particularly vulnerable, with a smoking rate two to five times higher than that of the general population. Quitting smoking has demonstrated benefits for mental health, including reducing stress and improving the quality of life. However, the economic feasibility of introducing Nicotine Replacement Therapy (NRT) in the psychiatric medical environment in South Africa has not yet been explored. This study aims to address this gap by assessing the impact on the budget of implementing an NRT-based smoking cessation program in a psychiatric hospital. METHODS: This retrospective and cross-sectional study followed a budget impact analysis framework. Data were retrieved between May 19 and Aug 18, 2023, from 214 patients' medical records. Using primary and secondary data, an ingredients costing approach was used to estimate direct treatment costs of NRT smoking cessation. All costs were expressed in ZAR (South African currency). The economic evaluation was conducted from the payer's perspective, and the results were reported at a 5% discount rate. A two-way 10% sensitivity analysis was conducted. RESULTS: The study showed that study participants were primarily black, male, unemployed, diagnosed with schizophrenia and smoked lightly (69.16% ±3.46). Implementing the 3-month treatment period of NRT smoking cessation program would result in an expenditure of R1 478 915.42 for 214 patients. The hospital will require an additional 0.15% (±0.0095) of the total hospital budget and 6.09% (±0.31) of the hospital pharmacy budget. CONCLUSION: Our findings indicate that while implementing a NRT is crucial for improving the overall health outcomes among patients with mental illnesses, substantial investment would be required. The budgetary allocation for NRT smoking cessation interventions would vary by treatment settings and program duration. Consequently, careful consideration of budget allocation and resource distribution is necessary to ensure the program's sustainability within the broader healthcare framework in South Africa.