Tobacco Cessation and Prevention: Tobacco Cessation and Prevention Slide |

Cost-Effectiveness of Universally Funding Smoking Cessation Pharmacotherapy FREE TO VIEW

Daniel Altman, MD; Fiona Clement, PhD; Lianne Barnieh, PhD; Braden Manns, MD; Erika Penz, MD
Author and Funding Information

University of Saskatchewan, Saskatoon, SK, Canada

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1303A. doi:10.1016/j.chest.2016.08.1418
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SESSION TITLE: Tobacco Cessation and Prevention Slide

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Sunday, October 23, 2016 at 07:30 AM - 08:30 AM

PURPOSE: Tobacco use is the leading cause of preventable death in Canada and worldwide. Funding smoking cessation pharmacotherapy increases the likelihood of smoking cessation pharmacotherapy use, number of quit attempts, and the probability of abstinence from smoking. Despite this, most provinces do not universally fund smoking cessation pharmacotherapy. The aim of our study was to model the cost-effectiveness of a health policy of universally funding smoking cessation pharmacotherapy for all Canadian smokers at no cost to the patient.

METHODS: Using data from a Cochrane Review meta-analysis, a decision model incorporating utilization of smoking cessation products, quit rates, six-month continuous abstinence rates, relapse rate, and direct costs of smoking cessation pharmacotherapy and physician visits associated with full funding of smoking cessation pharmacotherapy compared to no funding was constructed. Our primary outcome was the incremental cost per life-year gained of funding smoking cessation pharmacotherapy compared to no funding for the average Canadian smoker.

RESULTS: The average incremental cost per life-year gained of funding smoking cessation pharmacotherapy compared to no funding was $1210/life-year gained. The incremental cost per life-year gained for the subgroups of patients aged 30, 40, 50, 60 years old were $970, $930, $1200, and $2060 per life-year gained, respectively. Our results were robust to plausible variation in relative risk (RR) of six months of continuous abstinence, RR of using nicotine replacement therapy, RR of using bupropion/varenicline, discounted life-years gained, relapse rate, and average cost. Our model is also robust with respect to scenarios in which there is exclusive varenicline use, smoking cessation pharmacotherapy use without physician prescription, and no survival benefit for those quitting smoking at ages greater than 65. Funding smoking cessation therapy appears cost saving when smoking-related morbidity is incorporated.

CONCLUSIONS: Universally funding smoking cessation pharmacotherapy is a cost-effective intervention.

CLINICAL IMPLICATIONS: If we are to be consistent with the goals of promoting public health, then policy makers and government decision makers need to explore ways to deliver smoking cessation products to smokers in Canada without any financial burden.

DISCLOSURE: The following authors have nothing to disclose: Daniel Altman, Fiona Clement, Lianne Barnieh, Braden Manns, Erika Penz

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    Print ISSN: 0012-3692
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