RT Journal Article
SR Electronic
T1 Cost effectiveness of inpatient initiated varenicline tartrate (VT) plus counselling compared to counselling alone: 2 year follow-up of the Smoking Termination Opportunity for inPatients (STOP) study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4600
DO 10.1183/13993003.congress-2016.PA4600
VO 48
IS suppl 60
A1 Brian Smith
A1 Kristin Carson
A1 Kim Dalziel
A1 Malcolm Brinn
A1 Foruhar Moayeri
A1 Philip Clarke
A1 Matthew Peters
A1 Adrian Esterman
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA4600.abstract
AB Background: VT is currently the most effective smoking cessation pharmacotherapy available, yet its cost-effectiveness is unknown.Aims: To conduct a cost-effectiveness analysis for the use of VT in the inpatient setting.Methods: Adult smokers (n=392, 20-75 years) admitted to three metropolitan tertiary hospitals, were randomised to receive either 12-weeks of VT (titrated from 0.5mg daily to 1mg twice-daily) plus Quitline- a phone counselling service (C)(n=196) or C alone (n=196) with completion of the 12 week intervention post discharge. Two year follow-up information was combined with Markov model forecasts to quantify long-term impacts of trial outcome (i.e. observed quit rates) on costs and quality adjusted life year (QALY) gained.Results: At 2 years, there was a cost of $3,278 per additional person classified as an ex-smoker for the VT+C arm compared to the C arm. Incremental cost-effectiveness of hospital costs over a lifetime for VT+C compared to C was $26,688 per QALY. For the outcome of continuous abstinence at 12-months, the proportion of successful subjects in the VT+C arm was significantly greater with 31.1% (n=61) compared to 21.4% (n=42) in the QCA arm (RR 1.45, 95%CI 1.03 to 2.04, p=0.03). Statistical significance was maintained at 24 month follow-up (28.6 for VT+C group compared to 18.4% for QCA group; p=0.01).Conclusion: The trial effects modelled over a lifetime indicated that VT+C compared to C costs an estimated $28,688/QALY gained, which is cost-effective compared to many conventionally accepted therapies.