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.

Keywords:

• COPD
• cost-effectiveness
• smoking cessation

Acknowledgements

The authors acknowledge the contribution of C Gratziou (Evgenido Hospital Medical School, University of Athens), K Athanasakis (Research Fellow, National Scholl of Public Health), D Phiri and J Posnett (Heron Evidence Development) for their help with the research and preparation of this manuscript. The authors also thank S Diaz (Pfizer, Spain), E Vitsou (Pfizer, Greece), J Ezernieks (Pfizer, Germany), L Santoni (Pfizer, Italy) and I Kachaner (Pfizer, France) for their help in researching country-specific data inputs.

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