Original Title: 의료기술평가의 적용범위 확대를 위한 연구: 금연을 중심으로

Authors' objectives: The aim of this study was to investigate the domestic applicability of HTA in tobacco control field and to fill the gap due to the absences of domestic data by developing domestic research topic, which was to evaluate the association between quit-smoking and health-related quality of life (HRQoL).

Authors' recommendations: To find the domestic applicability of HTA in tobacco control field, we applied the minimally required data lists for the tobacco return on investment (ROI) provided by UK National Institute of Health and Care Excellence (NICE) and Brunel University. We found that Korea had advantages that it can utilize the national claims data of the National Health Insurance service (NHIS or the Insurance Review & Assessment (HIRA). However, as up-to-date data including prevalence and/or morbidity of smoking-related disease incidence and relative risk of disease was limited, it became the restriction for utilizing tobacco control ROI tool. Furthermore, due to the absences of data on the rate of smokers participating in smoking cessation programs provided at national, local, or private sector's level, the success ratio of smoking cessation, and data on disease-induced HRQoL, it was difficult to apply such domestic data to the ROI tool. By identifying the domestic applicability of HTA in tobacco control field, we found that the study on the impact of smoking cessation on HRQoL was limited, which are critical to conduct an economic evaluation. Thus, we assessed the association between smoking cessation and HRQoL using the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012). In the analysis, adult population at 19 years of age or older was included. Depending on the smoking status, they were categorized as non-smoker, current smoker, and ex-smoker. The dependent variable was EQ-5D value, which is a common instrument to measure HRQoL, and it was adjusted for demographic characteristics such as gender, age, educational level, occupation, marital status and income level and health related characteristics such as presence/absence of chronic diseases, recognition level of daily stress, and limitation on activities. A regression analysis with consideration of the complex sample design of the KNAHES was performed. A total of 17,303 adults were included in the analysis and it was identified that non-smokers, ex-smokers, and current smokers were accounted for 55.7%, 17.3%, and 27.0% respectively. The mean age of current smokers was 41.7 years (standard error (SE) 0.317), showing a lower tendency to the ages of non-smokers (mean 45.6 years, SE 0.273) and ex-smokers (mean 51.3 years, SE of 0.393). There was a difference in EQ-5D values, depending on the state of current smokers smoking an average of 0.959 (SE 0.002), ex-smoker as an average of 0.951 (SE 0.002), and non-smokers as an average of 0.941 (SE 0.001). After adjusting with socio-demographic variables and health-related variables, EQ-5D of ex-smokers was higher than current smokers by 0.010 (95% confidence interval from 0.005 to 0.014), and EQ-5D of non-smokers was also higher than current smokers by 0.008 (95% CI 0.004 to 0.013). Since this study was the first study carried out for the expansion of application targets for HTA, a subsequent study should be conducted in connection to this study. The outcomes of this study are expected to contribute not only to advancement of the national policies for domestic smoking cessation and preventive policies for smoking but also to the advancement of HTA in Korea.

Project Status: Completed

Year Published: 2015

URL for published report: https://www.neca.re.kr/lay1/program/S1T11C145/report/view.do?seq=158

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: South Korea

Organisation Name: National Evidence-based healthcare Collaborating Agency

Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), 3~5F Health and Welfare Social Administration B/D, 400 Neungdong-ro, Gwangjin-gu, Seoul, Korea.

Contact Name: int@neca.re.kr

Contact Email: int@neca.re.kr

Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)