PMH13 - Effect of Smoking Status on Costs-of-Illness in Patients with a Depressive Disorder in Spain: An Approximation from the National Health Survey

Abstract

Smoking in subjects with a depressive disorder (DD) is prevalent in Spain (~21% according to the Spanish National Health Survey-ENSE-), and it is expected to be related with healthcare resources utilization (HRU) and sick leaves accounting for substantial cost to the National Health System (NHS) and Society that still need to be characterized. The objective was to estimate the cost-of-illness in patients with a DD according to their smoking status. We used the year 2011/2012 ENSE to extract HRU and sick leaves, which is a representative general population-based survey of subjects 15+ years old. Male and female, 18+ years old with a self-revealed depressive disorder communicated by a physician were categorized according into smokers (daily smokers of any form of tobacco), former smokers of one or more years since quitting smoking and never smokers. HRU and sick leaves accounting for productivity loss were computed on an annualized basis. Multivariate general linear models adjusting for sex, age and number of comorbidities were applied. A total of 1,816 [mean age 62.4+15.4 years (76.9% female)] records were analyzed: 381 smokers, 290 former smokers, and 1,145 from never smokers. Smokers had higher both total and healthcare annual costs (€2941 and €2,283, respectively) than former smokers (€2,143 and €1,740) and never smokers (€2,397 and €1,866), p=0.061 and p=0.036: exceed cost of €798 and €543 (p=0.037 and p=0.029) and €543 and €417 (p=0.105 and p=0.042), respectively. Medical visits to healthcare professionals accounted for 54% of total annual costs while indirect costs depicted 22%. Subjects with a DD who still smoke are associated with higher HRU and costs from the societal perspective, when compared with both former and never smokers in the Spanish general population. As a consequence, quitting smoking in patients with a DD might be a value-for-money health policy in Spain.