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European-study on Quantifying the Utility of Investment in Protection from Tobacco equipt.eu
A tale of three decisions in public health: invest, invest more, disinvest
SubhashPokhrel,PhDDirector,DivisionofHealthSciences,BrunelUniversityLondon
Presentation outline
• Goalofresearch- supportdecisionmaking• Translationofresearchintopolicymaking
Whythisresearchcollaboration?
• Policyproposals• Lessonslearnt
Whathavewefound?
Acknowledgement and Disclaimer
• Collaborators– 35+scientistslocatedin9countries,13institutions
• Funding:NICE,DepartmentofHealth,MRC,EuropeanCommission
Allviewsexpressedintoday’stalkandanyerroraremyown.
Relevance?
Publichealth=Movingbenefitsfrom“ONE”to“MANY”
Fromclinicalefficacytopopulationhealth/wideroutcomes
Atwhatcost?
Three investment questions
Asadecisionmaker,
DoI continuetofundexistingservices?
DoIinvestinnew/additionalservices?
DoIdisinvestfromlesseffectiveservices?
Evidence transfer within Translational Research Framework
The EQUIPT study design
(ROI1.0)
The EQUIPT ROI Tool (EQUIPTMOD)
Economic costs of tobacco – 5 EQUIPT countries
TheEQUIPTStudyGroup(2016) http://equipt.eu/deliverables
England Germany Netherlands Hungary SpainDirect healthcare costs 4.73 15.12 2.50 1.24 14.09Second hand smoke healthcare costs 0.13 0.83 0.15 0.08 0.47Productivity losses 1.24 12.21 3.08 0.14 3.11Total 6.10 28.16 5.73 1.47 17.67
0.00
5.00
10.00
15.00
20.00
25.00
30.00€,
billio
n
An example: Increasing the reach of GP brief advice = improving ROI
594.9
269.5 211.4 21.83
917.1
12.1
8.97.4
0.56
17.8
0
100
200
300
400
500
600
700
800
900
1000
Curren
tand
add
ition
alinvestmen
t,millions,€
Currentinvestment Additionalinvestment
3.96
9.1
3.71 4.55 5.926.91
37.1
5.85
27.76
10.86
0
5
10
15
20
25
30
35
40
Bene
fit-Co
stra
tio
ROI(current) ROI(new)
Temporal returns (ROI) from prospective investment
TheEQUIPTStudyGroup(2016)http://equipt.eu/deliverables
Country-specific analyses
Country WhatpolicycouldprovidegoodROI?
Germany Improvingthe reachofGPbriefadviceandvarenicline
Netherlands Using internet-basedbehaviouralsupporttocomplementthecurrentprovisionofservices
Hungary Introducingsocial marketingcampaign
Spain ExpandingGPbriefadvicetowholecountryCoverageofpharmacotherapy
EnglandandtheNetherlands
ProvisionofcytisineImprovingreachofGPbriefadvice,group-basedsupport,SMStextmessagingsupport
Lessons learnt
• Co-production(withstakeholders)ofresearchhasbettervalue• UKMRCfundedSEE-Impactproject
• Needtosustainthecollaborationbeyondthefundingperiod– achallenge• WideruseofEQUIPTMOD/(http://equipt.eu)
• OpenAccesspublications• ~15scientificpeer-reviewedjournalarticles;Dedicatedwebportalforalldeliverables
• DedicationtowardsEQUIPT2!
Learnfromyesterday,Livefortoday,Hopefortomorrow.
Theimportantthingisnottostopquestioning.
- AlbertEinstein
Photocourtesy:https://commons.wikimedia.org/wiki/File:Albert_einstein_by_zuzahin-d5pcbug.jpg