Cost-effectiveness of pharmacotherapies for nicotine dependence in primary care settings: a multinational comparison.

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Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_3FB3949F5E98
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Cost-effectiveness of pharmacotherapies for nicotine dependence in primary care settings: a multinational comparison.
Périodique
Tobacco control
Auteur(s)
Cornuz J., Gilbert A., Pinget C., McDonald P., Slama K., Salto E., Paccaud F.
ISSN
1468-3318[electronic]
ISSN-L
0964-4563
Statut éditorial
Publié
Date de publication
2006
Peer-reviewed
Oui
Volume
15
Numéro
3
Pages
152-159
Langue
anglais
Résumé
OBJECTIVE: To estimate the incremental cost-effectiveness of the first-line pharmacotherapies (nicotine gum, patch, spray, inhaler, and bupropion) for smoking cessation across six Western countries-Canada, France, Spain, Switzerland, the United States, and the United Kingdom. DESIGN AND STUDY POPULATION: A Markov-chain cohort model to simulate two cohorts of smokers: (1) a reference cohort given brief cessation counselling by a general practitioner (GP); (2) a treatment cohort given counselling plus pharmacotherapy. Effectiveness expressed as odds ratios for quitting associated with pharmacotherapies. Costs based on the additional physician time required and retail prices of the medications. INTERVENTIONS: Addition of each first-line pharmacotherapy to GP cessation counselling. MAIN OUTCOME MEASURES: Cost per life-year saved associated with pharmacotherapies. RESULTS: The cost per life-year saved for counselling only ranged from US190 dollars in Spain to 773 dollars in the UK for men, and from 288 dollars in Spain to 1168 dollars in the UK for women. The incremental cost per life-year saved for gum ranged from 2230 dollars for men in Spain to 7643 dollars for women in the US; for patch from 1758 dollars for men in Spain to 5131 dollars for women in the UK; for spray from 1935 dollars for men in Spain to 7969 dollars for women in the US; for inhaler from 3480 dollars for men in Switzerland to 8700 dollars for women in France; and for bupropion from 792 dollars for men in Canada to 2922 dollars for women in the US. In sensitivity analysis, changes in discount rate, treatment effectiveness, and natural quit rate had the strongest influences on cost-effectiveness. CONCLUSIONS: The cost-effectiveness of the pharmacotherapies varied significantly across the six study countries, however, in each case, the results would be considered favourable as compared to other common preventive pharmacotherapies.
Mots-clé
Adult, Age Factors, Americas, Bupropion, Cost-Benefit Analysis, Drug Costs, Europe, Female, Health Care Costs, Humans, Male, Markov Chains, Middle Aged, Nicotine, Primary Health Care, Recurrence, Sex Factors, Smoking Cessation, Tobacco Use Disorder, Treatment Outcome
Pubmed
Web of science
Création de la notice
14/03/2008 11:12
Dernière modification de la notice
03/03/2018 16:25
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