Cost-effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD
Author
Trapero-Bertran, Marta
Muñoz, Celia
Coyle, Kathryn
Coyle, Doug
Lester-George, Adam
Leidl, Reiner
Németh, Bertalan
Cheung, Kei Long
Pokhrel, Subhash
López-Nicolás, Ángel
Publication date
2018ISSN
1360-0443
Abstract
Aims: To assess the cost‐effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). Design: We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov‐based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self‐helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion. A rate of 3% was used to discount life‐time costs and benefits. Setting: Spain. Participants: Adult smoking population (16+ years). Measurements: Health‐care costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality‐adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates. Findings: The cost of implementing the current provision of smoking cessation services is approximately €61 million in the current year. This translates to 18 quitters per 1000 smokers and a life‐time benefit–cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost‐saving: less expensive to run and generated more QALYs) from the life‐time perspective, compared with the current provision. The life‐time benefit–cost ratios were: 1.87 (proactive telephone calls); 1.17 (Rx NRT); 2.40 (varenicline‐standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis. Conclusions: According to the EQUIPTMOD modelling tool it would be cost‐effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro‐active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run.
Document Type
Article
Document version
Accepted version
Language
English
Subject (CDU)
33 - Economics. Economic science
Keywords
Finances
Comptabilitat
Hàbit de fumar
Tabac
Tabaquisme -- Tractament
Qualitat de vida
Finanzas
Contabilidad
Tabaco -- Consumo
Tabaco
Tabaquismo -- Tratamiento
Calidad de vida
Finances
Accounting
Smoking -- Habit
Tobacco
Smoking -- Treatment
Life, Quality of
Pages
11
Publisher
Wiley
Collection
113; S1
Is part of
Addiction
Citation
Trapero Bertrán, Marta; Muñoz, Celia; Coyle, Kathryn [et al.]. Cost-effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD. Addiction, 2018, 113(S1), p. 65-75. Disponible en: <https://onlinelibrary.wiley.com/doi/full/10.1111/add.14090>. Fecha de acceso: 24 may. 2020. DOI: 10.1111/add.14090.
Grant agreement number
info:eu-repo/grantAgreement/EC/FP7/602270
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Rights
© 2018 The Authors.Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms ofthe Creative Commons Attribution-NonCommercialLicense, which permitsuse, distributionand reproductionin any medium, provided the original work is properly cited and is not used for commercial purposes.
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc/4.0/