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

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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

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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