Smoking‐cessation therapy using varenicline: the cost‐utility of an additional 12‐week course of varenicline for the maintenance of smoking abstinence

Abstract

An additional 12-week course of varenicline treatment, provided to abstainers after an initial 12-week treatment, produces relatively low incremental cost-utility ratios in the spectrum of life-saving medical treatments.

What is the clinical effectiveness and cost-effectiveness of cytisine compared with varenicline for smoking cessation? A systematic review and economic evaluation

“…89 Other previous applications of the BENESCO model have used non-UK populations and parameter inputs, making comparison of total LYs and QALYs difficult. [62][63][64][66][67][68][69][70][71][72]89 However, results across these studies and here have been similar, in that the intervention with the greatest clinical effectiveness (short-term cessation probability) has consistently had the greatest cost-utility.…”

“…The BENESCO model has been used in numerous previous evaluations. [63][64][65][66][67][68][69][70][71][72][73] The model uses an annual cycle length and assumes that all smokers die at age 100 years, if death has not been simulated at an earlier age. A hypothetical cohort of 10,000 smokers enters the model, with each smoker assumed to make a single quit attempt, assisted by either varenicline or cytisine.…”

Model‐based economic evaluations in smoking cessation and their transferability to new contexts: a systematic review

“…A significant part of the intervention was smoking cessation programmes, either pharmacotherapy 4, 5, 36, 37, 38, 40, 41, 48, 50, 51, 53, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, behavioural therapy 6, 42, 47, 66, 67, 68, 69 or a combination of these 33, 34, 35, 43, 45, 46, 49, 52, 54, 70, 71, 72, 73, 74, 75. Several studies evaluated wider tobacco control interventions 39, 44, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, whereas five studies included both smoking cessation programmes and tobacco control interventions 89, 90, 91, 92, 93.…”

“…In total, 23 of 64 studies reported QALY as their main outcome 5, 35, 38, 40, 41, 47, 48, 49, 56, 58, 59, 61, 62, 63, 65, 69, 70, 76, 78, 81, 86, 88, 94, followed by life years (LY) gained ( n  = nine of 64) 33, 43, 46, 66, 67, 68, 73, 74, 89 or a combination of these ( n  = 12 of 64) 4, 6, 35, 36, 37, 39, 42, 44, 57, 77, 80, 83. Five of 64 studies reported disability adjusted life years (DALY) as their main outcome 60, 82, 90, 91, 92, and only four of 64 (incremental) net benefit 52, 53, 55, 71.…”

“…Thirty of 64 studies used a Markov model, 12 of which used a specific type called the benefits of smoking cessation on outcomes (BENESCO) model 4, 5, 36, 37, 48, 56, 57, 58, 59, 61, 62, 65. Decision‐tree models 41, 43, 52, 55, 63, 71, 75, 83, 93, discrete‐event simulations (DES) 45, 54, the chronic disease model (RIVM‐CDM) 44, 81, 88, the tobacco policy model (TPM) 76, 77, the quit benefits model (QBM) 80, the World Health Organization (WHO) model 90, the global health outcomes model (GHO model) 70 and the abstinent‐contingent treatment model (ABT model) 73 were also used.…”