The long-term cost-effectiveness of varenicline (12-week standard course and 12 + 12-week extended course) vs. other smoking cessation strategies in Canada

Wartburg, Markus von; Raymond, Vincent; Paradis, Pierre Emmanuel

doi:10.1111/ijcp.12363

Cited by 10 publications

(22 citation statements)

References 30 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…The populations in the analyses were described mainly as the general adult population of smokers. In three studies the populations were described further as smoking 20 cigarettes per day or more [33][34][35], making or considering a single or first quit attempt [36][37][38][39] or had recently tried to quit smoking [40,41]. In five studies the population was described only as a dynamic and/or hypothetical cohort [42][43][44][45][46] and in nine studies the population was not reported at all [47][48][49][50][51][52][53][54][55].…”

Section: Overview Of Studiesmentioning

confidence: 99%

See 2 more Smart Citations

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

et al. 2017

View full text Add to dashboard Cite

AimsTo identify different types of models used in economic evaluations of smoking cessation, analyse the quality of the included models examining their attributes and ascertain their transferability to a new context.MethodsA systematic review of the literature on the economic evaluation of smoking cessation interventions published between 1996 and April 2015, identified via Medline, EMBASE, National Health Service (NHS) Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA). The checklist‐based quality of the included studies and transferability scores was based on the European Network of Health Economic Evaluation Databases (EURONHEED) criteria. Studies that were not in smoking cessation, not original research, not a model‐based economic evaluation, that did not consider adult population and not from a high‐income country were excluded.FindingsAmong the 64 economic evaluations included in the review, the state‐transition Markov model was the most frequently used method (n = 30/64), with quality adjusted life years (QALY) being the most frequently used outcome measure in a life‐time horizon. A small number of the included studies (13 of 64) were eligible for EURONHEED transferability checklist. The overall transferability scores ranged from 0.50 to 0.97, with an average score of 0.75. The average score per section was 0.69 (range = 0.35–0.92). The relative transferability of the studies could not be established due to a limitation present in the EURONHEED method.ConclusionAll existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Overview Of Studiesmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A recent systematic review of CEAs 39 identified 4 studies published in the past 10 years which compared varenicline, bupropion, or NRT to each other or to standard of care. 20 , 26 , 57 , 58 All but one of these studies 58 also used the BENESCO model but none adjusted to account for safety outcomes. In agreement with our findings, the studies consistently found varenicline to be the most cost-effective intervention.…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Smoking Cessation Interventions in the United Kingdom Accounting for Major Neuropsychiatric Adverse Events

et al. 2021

View full text Add to dashboard Cite

Smoking is a leading cause of death worldwide. Cessation aids include varenicline, bupropion, nicotine replacement therapy (NRT), and e-cigarettes at various doses (low, standard and high) and used alone or in combination with each other. Previous cost-effectiveness analyses have not fully accounted for adverse effects nor compared all cessation aids. The objective was to determine the relative cost-effectiveness of cessation aids in the United Kingdom. Methods: An established Markov cohort model was adapted to incorporate health outcomes and costs due to depression and self-harm associated with cessation aids, alongside other health events. Relative efficacy in terms of abstinence and major adverse neuropsychiatric events was informed by a systematic review and network meta-analysis. Base case results are reported for UK-licensed interventions only. Two sensitivity analyses are reported, one including unlicensed interventions and another comparing all cessation aids but removing the impact of depression and self-harm. The sensitivity of conclusions to model inputs was assessed by calculating the expected value of partial perfect information. Results: When limited to UK-licensed interventions, varenicline standard-dose and NRT standard-dose were most costeffective. Including unlicensed interventions, e-cigarette low-dose appeared most cost-effective followed by varenicline standard-dose 1 bupropion standard-dose combined. When the impact of depression and self-harm was excluded, varenicline standard-dose 1 NRT standard-dose was most cost-effective, followed by varenicline low-dose 1 NRT standard-dose. Conclusion: Although found to be most cost-effective, combined therapy is currently unlicensed in the United Kingdom and the safety of e-cigarettes remains uncertain. The value-of-information analysis suggested researchers should continue to investigate the long-term effectiveness and safety outcomes of e-cigarettes in studies with active comparators.

show abstract

“…In up to one year of dosing, maintenance treatment with varenicline and counseling has been reported to be effective for sustained abstinence (Evins et al, 2014; Tonstad et al, 2006) and a cost-effective alternative to a 12-week treatment course. (Knight et al, 2012; von Wartburg et al, 2014). The demonstrated safety, tolerability, efficacy, and cost-effectiveness of maintenance varenicline make it an attractive option to improve long-term abstinence for smokers with and without SBD.…”

Section: Discussionmentioning

confidence: 99%

Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder

Evins

Hoeppner

Schoenfeld

et al. 2017

Schizophrenia Research

View full text Add to dashboard Cite

Objective To compare the effect of maintenance pharmacotherapy on sustained abstinence rates between recently abstinent smokers with schizophrenia and bipolar disorder (SBD) and general population smokers without psychiatric illness. Method We performed a person-level, pooled analysis of two randomized controlled trials of maintenance varenicline, conducted in adult smokers with SBD and general population smokers, controlling for severity of dependence. Smokers abstinent after 12-weeks of open varenicline treatment were randomly assigned to ≥12-weeks maintenance varenicline or identical placebo. Results In those assigned to maintenance placebo, the abstinence rate at week-24 was lower in those with SBD than for those without psychiatric illness (29.4±1.1% vs. 61.8±0.4%, OR:0.26, 95% CI: 0.13,0.52, p<0.001). In smokers assigned to maintenance pharmacotherapy, however, there was no effect of diagnosis on abstinence rates at week-24 (87.2±0.8% vs. 81.9 ± 0.2%, OR: 1.68, 95% CI: 0.53,5.32, p=0.38). Time to first lapse was shortest in those with SBD assigned to maintenance placebo (Q1=12 days, 95%CI: 4,16), longer in those without psychiatric illness assigned to maintenance placebo (Q1=17 days, 95%CI: 17,29), still longer in general-population smokers assigned to maintenance varenicline (Q1=88, 95% CI:58,91, and longest in those with SBD who received maintenance varenicline (Q1 ≥95 days, 95%CI:non-est), (Χ23df =96.99, p<0.0001; all pairwise comparisons p<0.001). Conclusions Following a standard 12-week course of pharmacotherapy, people with schizophrenia and bipolar disorder were more likely to relapse to smoking without maintenance varenicline treatment. Maintenance pharmacotherapy could improve longer-term tobacco abstinence rates and reduce known smoking-related health disparities in those with SMI.

show abstract

The long-term cost-effectiveness of varenicline (12-week standard course and 12 + 12-week extended course) vs. other smoking cessation strategies in Canada

Abstract: The standard and extended courses of varenicline are decidedly cost-effective treatment regimes compared with alternative smoking cessation interventions and can provide significant cost savings to the healthcare system.

Cited by 10 publications

References 30 publications

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

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

Cost-Effectiveness Analysis of Smoking Cessation Interventions in the United Kingdom Accounting for Major Neuropsychiatric Adverse Events

Maintenance pharmacotherapy normalizes the relapse curve in recently abstinent tobacco smokers with schizophrenia and bipolar disorder

Contact Info

Product

Resources

About