Higher Adherence during Reimbursement of Pharmacological Smoking Cessation Treatments
Menée à partir de données néerlandaises sur la période 2010-2013, cette étude évalue l'effet de l'arrêt du remboursement des traitements d'aide au sevrage tabagique (varénicline, bupropion) sur leur utilisation et leur observance
Introduction : In The Netherlands, pharmacologic Smoking Cessation Treatments (pSCTs) were reimbursed in 2011. In 2012 the reimbursement was discontinued. As of 2013, pSCTs were again reimbursed, provided they are accompanied by behavioural counselling. The aim of this paper is to assess the impact of changes in reimbursement policy on use of- and adherence to- pSCTs.
Methods : A retrospective dispensing database analysis was performed on real-world observational data (2010-2013) from The Netherlands. Data on use and adherence was collected, in patients who were dispensed bupropion or varenicline in community pharmacies for the first time. Using the InterActionDataBase (iadb.nl), adherence per patient that initiated varenicline or bupropion was calculated by adding up all dispenses between initiation of the therapy and the 120 days thereafter. Good adherence was defined as using minimal 80% of the recommended duration and intensity of use.
Results : The prevalence of patients initiating pSCTs was stable at 0.4 per 1,000 inhabitants per quarter during 2010. In 2011, the prevalence was on average 0.7, with peaks in the 1st (0.8 per 1,000) and 4th (1.0 per 1,000) quarters of 2011. In 2012, the prevalence was stable again at 0.3. In 2013, prevalence was on average 0.4, with a small peak in the 1st quarter. Adherence was 15.4% in 2010 versus and 20.1% in 2011 (P=0.002). In 2012, adherence was 13.9%, compared with 18.9% in 2013 (P=0.008).
Conclusions : Not only the likelihood of initiating pSCTs, but also the extent of adherence to these treatments, although generally low, seems higher during reimbursement.
Nicotine & Tobacco Research , résumé, 2015