ECONOMIC BURDEN OF CARDIOVASCULAR DISEASES ASSOCIATED WITH TOBACCO USE IN THE RUSSIAN FEDERATION IN 2016

Abstract

Abstract Objective: To estimate the economic burden of cardiovascular diseases (CVD) associated with tobacco use in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity. Design and method: The prevalence of tobacco use in the Russian population was determined in a ESSE-RF epidemiological study - 23.6%. The relative risks (RRs) of morbidity and mortality from CVD associated with tobacco use were identified through meta-analyzes and large studies. Based on the data on the prevalence of tobacco use in the Russian population and relative risks (RRs), the population attributable fractions (PAFs) was calculated for CVD. Associations were presented as RRs and PAFs with 95% CIs. PAF (%) = (P_exp (RR-1))/([P_exp (RR-1)] + 1), where: P_exp - the proportion of individuals in a population who are exposed to tobacco; RR - the relative risk of a specific outcome for a given exposure to a risk factor; To assess the economic burden, the proportion of the analyzed risk factor in the morbidity and mortality from CVD was determined, and then the proportion in the economic burden of the CVD. Then we estimated attributable costs by multiplying PAFs outcomes with estimated 2016 annual direct health care and indirect costs for CVD. We used data from the Federal State Statistics Service, parameters of Annual Forms of Federal Statistical Monitoring, the results of Program of state guarantees for free medical care and the corresponding diagnosis-related groups for 2016. The calculations were performed in Microsoft Excel 10.0. (Microsoft, USA). Results: The calculated PAFs, associated with tobacco use, for CVD mortality and morbidity was 13% and 9%, respectively. Economic burden of CVD associated with tobacco use in 2016 in the RF reached 335 billion rubles (4.7 billion €). The losses in the economy due to premature mortality (313.8 billion rubles) prevail in the structure of the main burden. Estimated direct costs were responsible up to 21 billion rubles. Conclusions: The significant economic burden associated with cardiovascular diseases provides an economic rationale for action to reduce the prevalence of lifestyle-related risk factors.