All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context
AIMS To 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 .
If you try to stop smoking, should we pay for it? The cost-utility of reimbursing smoking cessation support in the Netherlands.
BACKGROUND Smoking cessation can be encouraged by reimbursing the costs of smoking cessation support ( SCS ) . The short-term efficiency of reimbursement has been evaluated previously . However , a thorough estimate of the long-term cost-utility is lacking . OBJECTIVES To evaluate long-term effects of reimbursement of SCS . METHODS Results from a r and omized controlled trial were extrapolated to long-term outcomes in terms of health care costs and ( quality adjusted ) life years ( QALY ) gained , using the Chronic Disease Model . Our first scenario was no reimbursement . In a second scenario , the short-term cessation rates from the trial were extrapolated directly . Sensitivity analyses were based on the trial 's confidence intervals . In the third scenario the additional use of SCS as found in the trial was combined with cessation rates from international meta-analyses . RESULTS Intervention costs per QALY gained compared to the reference scenario were approximately euro1200 extrapolating the trial effects directly , and euro4200 when combining the trial 's use of SCS with the cessation rates from the literature . Taking all health care effects into account , even costs in life years gained , result ed in an estimated incremental cost-utility of euro4500 and euro7400 , respectively . In both scenarios costs per QALY remained below euro16 000 in sensitivity analyses using a life-time horizon . CONCLUSIONS Extrapolating the higher use of SCS due to reimbursement led to more successful quitters and a gain in life years and QALYs . Accounting for overheads , administration costs and the costs of SCS , these health gains could be obtained at relatively low cost , even when including costs in life years gained . Hence , reimbursement of SCS seems to be cost-effective from a health care perspective
All existing economic evaluations in smoking cessation lack in one or more key study attributes necessary to be fully transferable to a new context
AIMS To 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 .