Economic Evaluation of Pharmaco- and Behavioral Therapies for Smoking Cessation: A Critical and Systematic Review of Empirical Research

Ruger, Jennifer Prah; Lazar, Christina M.

doi:10.1146/annurev-publhealth-031811-124553

Cited by 43 publications

(35 citation statements)

References 75 publications

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“…Direct comparison of our results with published findings is challenging given the variability in the metrics of abstinence reported in other trials, the length of follow-up, the economic evaluation methods used and the study setting 40 53. Previous studies have used varying metrics for reporting costs, with some using average cost per quitter, and others (including ours) including both average cost per quitter and incremental cost-effectiveness 54.…”

Section: Discussionmentioning

confidence: 85%

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Graham

Chang

et al. 2012

Tob Control

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Background Internet and telephone treatments for smoking cessation can reach large numbers of smokers. There is little research on their costs and the impact of adherence on costs and effects. Objective To conduct an economic evaluation of The iQUITT Study, a randomised trial comparing Basic Internet, Enhanced Internet and Enhanced Internet plus telephone counselling (‘Phone’) at 3, 6, 12 and 18 months. Methods We used a payer perspective to evaluate the average and incremental cost per quitter of the three interventions using intention-to-treat analysis of 30-day single-point prevalence and multiple-point prevalence (MPP) abstinence rates. We also examined results based on adherence. Costs included commercial charges for each intervention. Discounting was not included given the short time horizon. Results Basic Internet had the lowest cost per quitter at all time points. In the analysis of incremental costs per additional quitter, Enhanced Internet+Phone was the most cost-effective using both single and MPP abstinence metrics. As adherence increased, the cost per quitter dropped across all arms. Costs per quitter were lowest among participants who used the ‘optimal’ level of each intervention, with an average cost per quitter at 3 months of US$7 for Basic Internet, US$164 for Enhanced Internet and US$346 for Enhanced Internet +Phone. Conclusions ‘Optimal’ adherence to internet and combined internet and telephone interventions yields the highest number of quitters at the lowest cost. Cost-effective means of ensuring adherence to such evidence-based programmes could maximise their population-level impact on smoking prevalence.

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Section: Discussionmentioning

confidence: 85%

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Graham

Chang

et al. 2012

Tob Control

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“…Although there is good evidence to show the cost effectiveness of TDT in HICs (Ruger & Lazar, 2012), not all interventions may be deemed cost effective when assessed against gross domestic product per capita in LMICs. This is illustrated in Vietnam, a lower MIC, where brief advice was "very cost effective," but pharmaceuticals at their current cost were not cost effective (Higashi & Barendregt, 2012).…”

Section: Refinement Of Tdtmentioning

confidence: 99%

Research Priorities for Article 14--Demand Reduction Measures Concerning Tobacco Dependence and Cessation

McRobbie

Raw

Chan

2012

Nicotine & Tobacco Research

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“…1,3,4 Multiple tobacco cessation interventions have been shown to be cost effective, or even cost saving in some cases, across a broad range of populations. [5][6][7][8] These interventions include varenicline, sustained-release bupropion, nicotine replacement therapies (NRTs, such as gums and patches), and counseling interventions. While U.S. Public Health Service guidelines on tobacco use and dependence recommend that clinicians offer brief counseling interventions to all patients who use tobacco, rates of tobacco dependence detection and treatment in primary care have historically been suboptimal.…”

Section: Introductionmentioning

confidence: 99%

Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

et al. 2016

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BACKGROUND: Tobacco use is the leading cause of preventable death and disability. New payment and delivery system models including global payment and accountable care have the potential to increase use of cost-effective tobacco cessation services. OBJECTIVE: To examine how the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA) has affected tobacco cessation service use. DESIGN: We used 2006-2011 BCBSMA claims and enrollment data to compare adults 18-64 years in AQC provider organizations to adults in non-AQC provider organizations. We examined the AQC's effects on all enrollees; a subset at high risk of tobacco-related complications due to certain medical conditions; and behavioral health service users. MAIN MEASURES: We examined use of: (1) any cessation treatment (pharmacotherapy or counseling); (2) varenicline or bupropion; (3) nicotine replacement therapies (NRTs); (4) cessation counseling; and (4) combination therapy (pharmacotherapy plus counseling). We also examined duration of pharmacotherapy use and number of counseling visits among users. KEY RESULTS: Rates of tobacco cessation treatment use were higher following implementation of the AQC relative to the comparison group overall (2.02 vs. 1.87 %, p < 0.0001), among enrollees at risk for tobacco-related complications (4.97 vs. 4.66 %, p < 0.0001), and among behavioral health service users (3.67 vs. 3.25 %, p < 0.0001). Statistically significant increases were found for use of varenicline or bupropion alone, counseling alone, and combination therapy, but not for NRT use, pharmacotherapy duration, or number of counseling visits among users. CONCLUSIONS: In its initial three years, the AQC was associated with increases in use of tobacco cessation services.

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Economic Evaluation of Pharmaco- and Behavioral Therapies for Smoking Cessation: A Critical and Systematic Review of Empirical Research

Cited by 43 publications

References 75 publications

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Research Priorities for Article 14--Demand Reduction Measures Concerning Tobacco Dependence and Cessation

Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

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