Potential health impacts of increasing the cigarette tax in Viet Nam.

BACKGROUND: Even after the implementation of MPOWER, Viet Nam's cigarette tax remains only 36% of the retail price. This falls short of the World Health Organization's (WHO's) recommendation that the tax share be 70% of the retail price. OBJECTIVE: To assess the health impact of different levels of cigarette taxation by estimating the impact on reducing tobacco consumption and smoking-attributable deaths (SADs). METHODS: A static model was developed based on a previous study by Jha et al. The model calculates the reduction in tobacco consumption, estimating the number of SADs averted and savings in health-related costs. The scenarios for increasing cigarette taxes were aligned with the Viet Nam Tobacco Tax Simulation Model developed by the WHO and the Vietnamese Ministry of Finance. RESULTS: Four scenarios proposed by the Ministry of Finance and the Ministry of Health would prevent an estimated 63 339-581 165 SADs, equivalent to mortality costs of US$577-5296 million. In the ideal scenario, 6 258 361 SADs would be prevented and would save US$57.0 billion. Future young smokers would see the greatest health benefits of increasing the cigarette tax. CONCLUSION: Increasing the cigarette tax could reduce the substantial health impact of tobacco use, and further result in significant financial savings across society. Viet Nam should support efforts to further increase the cigarette tax following WHO recommendations.

Costs of providing tuberculosis diagnosis and treatment services in Viet Nam.

OBJECTIVE: To estimate the cost of providing tuberculosis (TB) diagnosis and treatment packages at different levels of health facilities in Viet Nam. DESIGN: This was a retrospective costing study from the providers' perspective using a standard costing approach. We included typical services for TB diagnosis and treatment based on standard protocols. RESULTS: The least expensive TB service was the 6-month isoniazid preventive therapy regimen for latent tuberculous infection provided by district health centres (US$7.20-14.30, accounting for 0.3-0.7% of Viet Nam's per capita gross domestic product [GDP] of US$2052.30 in 2014). The cost of diagnosing and treating a patient with drug-susceptible TB (the most common type of TB) ranged between US$51.20 and US$180.70, and represented 2.5-8.8% of Viet Nam's per capita GDP in 2014. The most expensive TB service was the diagnosis and treatment of a multidrug-resistant TB case (US$1568.20-2391.20), accounting for 76.4-116.5% of Viet Nam's per capita GDP in 2014). CONCLUSION: The cost of TB diagnosis and treatment services in Viet Nam varied according to level of health facility, type of TB, different costing options, and different staff cost scenarios.