Cost effectiveness analysis of smoking cessation interventions

Shearer, James; Shanahan, Marian

doi:10.1111/j.1467-842x.2006.tb00458.x

Cited by 52 publications

(40 citation statements)

References 38 publications

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“…Despite this, almost all cost-effectiveness studies made allowances for the adjustment of the natural quit rate (Buck, Richmond, & Mendelsohn, 2000;Gilbert et al, 2004;Ronckers et al, 2005;Shearer & Shanahan, 2006). Hence, the intended omission in this study limited the generalisation of results of this study.…”

Section: Strength and Limitationsmentioning

confidence: 82%

Treatment Outcome Assessment of the Pharmacist-Managed Quit Smoking Clinic in Malaysia

2014

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I ntroduction: Evaluating a new health service is different from evaluating a new drug, as the former depends on the local delivery structure and culture. No data are available on the effectiveness of the existing pharmacist-managed quit smoking clinic (PM-QSC) in Malaysia. We evaluated the effectiveness in terms of the quit and default rate, the cost per quitter, cost per patient and the number of days of the patient remained in the managed care of the pharmacist. Methods: The patients' medical records at the PM-QSC in a tertiary hospital in Melaka, Malaysia, were examined retrospectively from January 2009 to December 2010. Patients were grouped into current smokers, attempted to quit and quitters. Costs were calculated per patient visit on the basis of resource used (smoking cessation agents (SCAs)) and the personnel involved (time spent by the pharmacist). This study was reviewed and approved by the Malaysia Research Ethics Committee (MREC). Results: The quit rate between January 2009 and December 2010 was 5.8%, and the default rate was 71.8%. The average quit period for all smokers enrolled was 298 days. From the health provider perspective, the average costs per quitter, per patient and per quit attempt were MYR 953.28 (USD 308), MYR 55.71 (USD 18) and MYR 34.74 (USD 11), respectively. Conclusion: The pharmacist delivery of cessation services at a public-funded QSC was associated with a high default rate. The pharmacist could not be dismissed entirely as an ineffective health care professional (HCP) for the provision of the cessation service based solely on this preliminary data, but these findings stress the need to address the high default rate prior to the expansion of the service.

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Section: Strength and Limitationsmentioning

confidence: 82%

Treatment Outcome Assessment of the Pharmacist-Managed Quit Smoking Clinic in Malaysia

2014

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“…For such diseases, they are accepted as gold standard treatments in terms of cost effectiveness [20][21][22][23]. Moreover, more premature births can be prevented by the treatment of smoker pregnant women for cessation.…”

Section: Discussionmentioning

confidence: 99%

Can a Computer-Based Prescription of Free Medication Increase Smoking Cessation Rates Efficiently?

Fidan¹,

Çağlayan²,

Parmaksız³

et al. 2015

Turk Thorac J

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OBJECTIVES:In 2011, in the context of a research project, bupropion and varenicline were distributed to smoking cessation clinics by the Ministry of Health of Turkey to be prescribed free of charge by a computer-based system. In the present study, we compared smoking cessation rates between patients who were prescribed free medications during the period of the project and those who had to pay for their medication. MATERIAL AND METHODS:Six hundred four patients who applied during the project period were given either bupropion or varenicline, which were prescribed using an algorithm-based computer system. Three hundred sixteen patients who applied after that period were prescribed medicines deemed appropriate by the attending physician but had to pay for the medication on their own. Follow-up visits were arranged for one year. Carbon monoxide (CO) levels in the expired air were used as indicators of cessation. RESULTS:A total of 537 patients began treatment, of which 438 (81.6%) applied during the first period (group 1) and 99 (18.4%) applied during the second period (group 2). The mean age and concomitant disease presence were higher in the second-period patients (p< 0.05). Advanced age, comorbidities, pathological findings in spirometry, and chest X-ray were also higher in those who paid for the cost of their treatment (p= 0.009, 0.001, 0.006, 0.001, respectively). Smoking cessation rates were found to be 14.8% and 27.3% after six months (p= 0.008) and 10.7% and 18.2% after one year (p= 0.059), respectively, for group 1 and group 2. Age, dependence score, cigarettes smoked (as pack-years), and percentage of patients who paid for the treatment were found to be significantly higher (p< 0.001, 0.021, 0.018, 0.001, respectively) for those who quit smoking at the end of six months. For the patients who quit smoking at the end of one year, age was found to be significantly higher (p= 0.008), and the number of males was higher, although the difference was not statistically significant (p= 0.05). When logistic regression analysis was applied, age, dependence score, and paid treatment were found to be independent variables (p= 0.002, 0.008, 0.012, respectively) for those who quit smoking at the end of six months. Only age was found to be an independent variable for those who quit smoking at the end of one year (p= 0.029). CONCLUSION:More smokers could receive treatment by the distribution of free drugs. However, quitting rates at the end of six months were higher when patients had to pay for their treatment. On the other hand, quitting rates at the end of one year were not affected by whether the treatment was paid for or free of charge. The most important factor increasing quitting rates at the end of six months and one year was found to be advanced age.

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“…Although utility scores (EQ-5D) (The Euroqol Group, 1990) will be measured at the beginning and end of the study period, previous studies have demonstrated that the cost effectiveness of smoking-cessation programs is very dependent on the quit rates at 12 months and subsequent relapse rates (Cromwell, Bartosch, Fiore, Baker, & Hasselblad, 1998;Hughes, Peters, & Naud, 2008;Shearer & Shanahan, 2006). As the long-term benefits from smoking cessation (e.g., avoided cases of lung cancer) may not be evident for many years, the analysis will use a Markov state transition model to track costs and QALYs for a hypothetical cohort model of participants moving between specified health states at the end of each cycle.…”

Section: Cost-effectiveness Informationmentioning

confidence: 99%

Design and conduct of a pragmatic randomized controlled trial to enhance smoking-cessation outcomes with exercise: The Fit2Quit study

Maddison

Roberts

Bullen

et al. 2010

Mental Health and Physical Activity

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Cost effectiveness analysis of smoking cessation interventions

Cited by 52 publications

References 38 publications

Treatment Outcome Assessment of the Pharmacist-Managed Quit Smoking Clinic in Malaysia

Treatment Outcome Assessment of the Pharmacist-Managed Quit Smoking Clinic in Malaysia

Can a Computer-Based Prescription of Free Medication Increase Smoking Cessation Rates Efficiently?

Design and conduct of a pragmatic randomized controlled trial to enhance smoking-cessation outcomes with exercise: The Fit2Quit study

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