University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands.
Mongolian National University of Medical Sciences, Department of Health Policy, School of Public Health, Ulaanbaatar, Mongolia.
J Glob Health. 2020 Dec;10(2):020437. doi: 10.7189/jogh.10.020437.
Economic evaluations of tobacco control interventions support decisions regarding resource allocation in public health policy. Our systematic review was aimed at identifying potential bias in decision models used to estimate the long-term costs and effects of population-based tobacco control interventions in Asia.
We included studies conducted in Asian countries and using a modelling technique to evaluate the economic impacts of one or more population-based tobacco interventions in line with the Framework Convention on Tobacco Control (FCTC). We assessed the structure, input parameters, and risk of bias for each model, and performed a narrative synthesis of the included studies.
Nine model-based economic evaluation studies of population-based tobacco interventions were identified. About 60% of the criteria for reporting quality were met in all studies, indicating that reporting generally lacked transparency. The studies were highly heterogeneous in terms of the scope, types, and structures of their models and the quality of input parameters. One-third of the models applied in the studies scored a high risk of bias, with problems mostly falling into the following categories: model type, time horizons, and smoking transition probabilities.
More data are needed to provide high-quality evidence regarding the cost-effectiveness of tobacco control policies in Asia. Strong evidence at the country level hinges on the availability of accurate estimates of the effects of the interventions, the relative risks of smoking, and the price elasticity of the demand for tobacco. Simple transfers of models built in Western populations do not suffice.
PROSPERO CRD 42019141679.
对烟草控制干预措施的经济评估支持公共卫生政策中资源分配的决策。我们的系统评价旨在确定用于估计亚洲基于人群的烟草控制干预措施的长期成本和效果的决策模型中是否存在潜在偏差。
我们纳入了在亚洲国家开展的、使用建模技术评估一种或多种基于人群的烟草干预措施的经济影响的研究，这些研究符合《烟草控制框架公约》（FCTC）。我们评估了每个模型的结构、输入参数和偏差风险，并对纳入的研究进行了叙述性综合。
确定了 9 项基于人群的烟草干预措施的基于模型的经济评估研究。所有研究均满足报告质量标准的 60%左右，表明报告通常缺乏透明度。这些研究在模型的范围、类型和结构以及输入参数的质量方面存在很大的异质性。三分之一的研究模型存在高偏差风险，问题主要集中在以下几个方面：模型类型、时间范围和吸烟转移概率。
需要更多的数据来提供亚洲烟草控制政策成本效益的高质量证据。在国家层面上的有力证据取决于干预措施效果、吸烟相对风险和烟草需求价格弹性的准确估计数据。简单地转移在西方人群中建立的模型是不够的。
PROSPERO CRD42019141679。
