A review of cost‐effectiveness of varenicline and comparison of cost‐effectiveness of treatments for major smoking‐related morbidities

Zimovetz, Evelina; Wilson, Koo; Melamed, Samuel; Beard, Stephen

doi:10.1111/j.1365-2753.2010.01439.x

Cited by 14 publications

(15 citation statements)

References 41 publications

(55 reference statements)

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“…The results of this economic evaluation closely follow the results reported by Wilson et al, comparing varenicline plus counselling to placebo plus counselling in patients with CVD in Spain, Italy, Portugal and Belgium [10], and the more general results comparing varenicline to alternative therapies in various populations, as reported in Zimovetz et al, [9]. As with Wilson et al, [10], the Markov model reported in this paper is based on an adjusted version of the previously published BENESCO model [11], and the extrapolation of outcomes from a single randomized placebo-controlled trial for varenicline plus brief counselling [8].…”

Section: Discussionsupporting

confidence: 72%

“…From an economic perspective, over 20 studies have previously demonstrated that varenicline is a cost-effective intervention for smoking cessation from both the health care payer and employers perspective, with incremental costeffectiveness ratio's ranging from dominance to 18 582 per Quality Adjusted Life Year (QALY) gained [9]. Recently, a de novo economic evaluation of smoking cessation treatment in patients with CVD in Spain, Portugal, Belgium and Italy extended this evidence base to those with pre-existing conditions and who are at high risk of morbidity and mortality [10].…”

Section: Introductionmentioning

confidence: 99%

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Cost-Effectiveness of Varenicline Compared to Placebo as an Aid to Smoking Cessation in Patients with Cardiovascular Disease

Hettle¹

2012

TOPHARMEJ

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Background:Varenicline has been shown to be an effective and well-tolerated intervention for smoking cessation in smokers with stable cardiovascular disease (CVD). The objective of this study was to evaluate the costeffectiveness of varenicline and counselling compared to placebo and counselling based on extrapolating the results of a 52-week randomised controlled trial.Method: A Markov model was developed to simulate the outcomes of smokers with CVD. Outcomes included major forms of CVD (e.g. Coronary Heart Disease [CHD]) and other key chronic conditions attributable to smoking (e.g. Lung Cancer). The lifetime costs, Life-Years gained (LY) and Quality-Adjusted Life Years (QALY) were evaluated from a payer's perspective in Austria, Hungary and Germany. Additional analyses included a societal perspective, disease subgroup, and both one-way and probabilistic sensitivity analyses (PSA). Costs and outcomes were discounted at 3% per year.Results: From a payer's perspective, the incremental cost-effectiveness ratio per LY (or QALY) gained was 4 112 ( 5 278), 2 507 ( 3 183), and 4 567 ( 5 867) for Austria, Hungary and Germany, respectively. Sub-group analyses demonstrated that smoking cessation in patients with CHD was more cost-effective than in patients with baseline stroke or peripheral vascular disease. Sensitivity analysis demonstrated that outcomes were not sensitive to modelling assumptions. Varenicline was less costly and more effective than placebo from a societal perspective, and more costly and more effective than placebo in all iterations of the payer PSA. Conclusions:Varenicline is a cost-effective adjunct to counselling compared to counselling alone in patients with stable CVD.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Varenicline Compared to Placebo as an Aid to Smoking Cessation in Patients with Cardiovascular Disease

Hettle¹

2012

TOPHARMEJ

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“…Smoking cessation programs are the sole area of behavioral research well tested with COPD patients. These RCTs are largely focused on smoking-cessation medications [31][32][33] ]. Reminder calls, education, behavioral support, ongoing monitoring, reduced copayments, and decision aids all succeeded, to varying degrees, in increasing adherence.…”

Section: Interventions To Improve Adherencementioning

confidence: 99%

Nonadherence in chronic obstructive pulmonary disease patients

Bender

2014

Current Opinion in Pulmonary Medicine

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Purpose of reviewAlthough nonadherence research in patients with chronic obstructive pulmonary disease (COPD) lags well behind other diseases, new evidence helps inform understanding about the degree and underlying causes of patient nonadherence, interventions that can improve adherence, and areas of research needed to further progress in improving this problem in patients with COPD. Recent findingsFewer than half of treatments for COPD, including oxygen supplementation, physical rehabilitation, and medication, are taken as prescribed. Most patients abandon their treatment after an initial start. Nonadherence in turn contributes to rising rates of hospitalization, death, and healthcare costs. The reasons why patients choose not to use their COPD treatments are not fully understood, although depression is clearly a contributing factor. Although a substantial number of studies have tested adherence interventions, few have included COPD patients or addressed polypharmacy in patients with multiple comorbidities. SummaryThe paucity of research does not reflect the inadequacy of available treatments. Lessons learned from the research outside of COPD and a small number of COPD studies suggest that a collaborative care approach will likely provide the most potential for improving overall care, including management of depression and enhancement of adherence. Exploitation of mobile telephone technology to engage patients in a discussion of their self-care should not be ignored as a potential intervention for COPD patients.

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“…12 The cost per QALY has been estimated to range between £494 (€654; $716) and £3554 for NRT, between £316 and £2212 for bupropion, and between £950 and £1140 for varenicline. [12][13][14] How are they taken and monitored?…”

Section: Bupropionmentioning

confidence: 99%