A cost-effectiveness model of smoking cessation based on a randomised controlled trial of varenicline versus placebo in patients with chronic obstructive pulmonary disease.

Abstract

OBJECTIVES:

Smoking is an important risk factor in chronic obstructive pulmonary disease (COPD). A recent clinical trial demonstrated the efficacy of varenicline versus placebo as an aid to smoking cessation in patients with COPD. This study examines the cost-effectiveness of varenicline from the perspective of the healthcare systems of Spain (base case), the UK, France, Germany, Greece and Italy.

METHODS:

A Markov model was developed to determine the cost-effectiveness of varenicline as an aid to smoking cessation, compared to a placebo, in a COPD population. Cost-effectiveness was determined by the incremental cost per quality-adjusted life year (QALY) gained.

RESULTS:

In the Spanish base case varenicline had an incremental cost of €1021/person for an average of 0.24 life years (0.17 QALYs), gained over the lifetime of a cohort of COPD patients, resulting in an incremental cost-effectiveness ratio (ICER) of €5,566. In the other European countries, the ICER varied between €4,519 (UK) and €10,167 (Italy). Probabilistic sensitivity analysis suggested varenicline had a high probability (>95%) of being cost-effective at a threshold of €30,000/QALY.

CONCLUSIONS:

Varenicline is expected to be a cost-effective aid to smoking cessation in COPD patients in all of the countries studied.

• Authors: Kevin Lock, Koo Wilson, Daniel Murphy, Juan Antonio Riesco
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 12 Issue 17 Pg. 2613-26 (Dec 2011) ISSN: 1744-7666 [Electronic] England
• PMID: 22017336 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Benzazepines
• Nicotinic Agonists
• Quinoxalines
• Varenicline

Topics

• Benzazepines (economics, therapeutic use)
• Cost-Benefit Analysis
• Europe
• Female
• Humans
• Male
• Markov Chains
• Middle Aged
• Models, Economic
• Nicotinic Agonists (economics, therapeutic use)
• Pulmonary Disease, Chronic Obstructive (drug therapy, economics)
• Quinoxalines (economics, therapeutic use)
• Randomized Controlled Trials as Topic
• Smoking Cessation (economics)
• Varenicline