The importance of evidence-based health policy is widely acknowledged among health care professionals, patients and politicians. Health care resources available for medical procedures, including pharmaceuticals, are limited all over the world. Economic evaluations help to alleviate the burden of scarce resources by improving the allocative efficiency of health care financing. Reimbursement of new medicines is subject to their cost-effectiveness and affordability in more and more countries. There are three major approaches to calculate the cost-effectiveness of new pharmaceuticals. Economic analyses alongside pivotal clinical trials are often inconclusive due to the suboptimal collection of economic data and protocol-driven costs. The major limitation of observational naturalistic economic evaluations is the selection bias and that they can be conducted only after registration and reimbursement. Economic modelling is routinely used to predict the cost-effectiveness of new pharmaceuticals for reimbursement purposes. Accuracy of cost-effectiveness estimates depends on the quality of input variables; validity of surrogate end points; and appropriateness of modelling assumptions, including model structure, time horizon and sophistication of the model to differentiate clinically and economically meaningful outcomes. These economic evaluation methods are not mutually exclusive; in practice, economic analyses often combine data collection alongside clinical trials or observational studies with modelling. The need for pharmacoeconomic evidence has fundamentally changed the strategic imperatives of research and development (R&D). Therefore, professionals in pharmaceutical R&D have to be familiar with the principles of pharmacoeconomics, including the selection of health policy-relevant comparators, analytical techniques, measurement of health gain by qualityadjusted life-years and strategic pricing of pharmaceuticals.

The economic crisis may create an opportunity to further strengthen the evidence base of health care decision-making in Hungary. In the forthcoming period ISPOR Hungary Chapter may play an even more crucial role in improving the standards of HTA implementation and facilitating international collaboration with other CEE countries.

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Összefoglaló. A dohányzás hazai viszonylatban és globálisan is óriási terheket ró a társadalomra, a gazdaságra és az egyénekre. A COVID–19 járványhelyzetben fontos kiemelni, hogy a jelenleg rendelkezésre álló tudásunk alapján a dohányzás is azon rizikótényezők közé tartozik, melyek növelik a súlyos lefolyású koronavírus-fertőzés kockázatát. Óriási mértékű lobbitevékenység veszi körül a dohányzás területét. A dohányipar a rendelkezésre álló és nyilvánvaló tudományos bizonyítékok ellenére is mindent elkövet annak érdekében, hogy nehezítse a dohányzás leküzdését célzó népegészségügyi intézkedések és törekvések bevezetését és végrehajtását. A dohányipar már a 20. század közepétől kísérletezik alternatív dohánytermékek kifejlesztésével, amellyel ellensúlyozhatja a klasszikus dohánytermékek fogyasztásának visszaesését. Különböző taktikai megoldásokkal, folyamatos innovációval és új típusú dohánytermékek piacra dobásával (pl. hevített) a dohányipar próbálja a hagyományos dohánytermékek csökkenéséből eredő problémáit ellensúlyozni, valamint – a fogyasztókat, döntéshozókat gyakran megtévesztve – a piacukat és az addikciót meg-, illetve fenntartani. Tanulmányunk célja a dohányipari befolyásolási technikákkal összefüggő legfrissebb információk áttekintése mellett a hevített dohánytermékekkel kapcsolatban elérhető tudományos bizonyítékok összefoglalása, valamint a COVID–19 és a dohányzás közötti kapcsolat ismertetése. Jelen áttekintés a PubMed adatbázisban elérhető publikációkon, valamint hazai és nemzetközi tudományos intézetek honlapján közölt összefoglalókon és felméréseken alapul. Summary. Smoking causes a huge burden on society, economy and individuals, both domestically and globally. During the COVID-19 pandemic, it is important to highlight that, to the best of our current knowledge, smoking is also one of the risk factors that increases the risk of severe coronavirus infection. There are enormous lobbying efforts surrounding the tobacco area. Despite the available and clear scientific evidence, the tobacco industry is doing its utmost to make it more difficult to introduce and implement public health measures and efforts to combat smoking. The tobacco industry has been experimenting with the development of alternative tobacco products since the mid-20th century to offset the decline in consumption of classic tobacco products. Therefore, by using different tactics, the tobacco industry applies continuous innovation and launches new types of tobacco products (e.g. heated), to countervail its problems arising from the decrease of traditional tobacco products, to retain their markets, and to maintain addiction by often misleading consumers and decision-makers. The aims of our study are to review the most recent knowledge about the tobacco industry interference, to summarize available scientific evidence related to heated tobacco products, and to present the current association between COVID-19 and smoking. This review summarizes the existing knowledge based on publications in the PubMed database and on reviews and research data published by national and international scientific institutions.

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