Cost-effectiveness of varenicline and three different behavioral treatment formats for smoking cessation
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There is a lack of evidence of the relative cost-effectiveness of proactive telephone counseling (PTC) and Web-based delivery of smoking cessation services in conjunction with pharmacotherapy. We calculated the differential cost-effectiveness of three behavioral smoking cessation modalities with varenicline treatment in a randomized trial of current smokers from a large health system. Eligible participants were randomized to one of three smoking cessation interventions: Web-based counseling (n = 401), PTC (n = 402), or combined PTC-Web counseling (n = 399). All participants received a standard 12-week course of varenicline. The primary outcome was a 7-day point prevalent nonsmoking at the 6 month follow-up. The Web intervention was the least expensive followed by the PTC and PTC-Web groups. Costs per additional 6-month nonsmoker and per additional lifetime quitter were $1,278 and $2,601 for Web, $1,472 and $2,995 for PTC, and $1,617 and $3,291 for PTC-Web. Cost per life-year (LY) and quality-adjusted life-year (QALY) saved were $1,148 and $1,136 for Web, $1,320 and $1,308 for PTC, and $1,450 and $1,437 for PTC-Web. Based on the cost per LY and QALY saved, these interventions are among the most cost-effective life-saving medical treatments. Web, PTC, and combined PTC-Web treatments were all highly cost-effective, with the Web treatment being marginally more cost-effective than the PTC or combined PTC-Web treatments.
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- Cost-effectiveness of varenicline and three different behavioral treatment formats for smoking cessation
Translational Behavioral Medicine
Volume 1, Issue 1 , pp 182-190
- Cover Date
- Print ISSN
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- Smoking cessation
- Quality-adjusted life-years saved
- Behavioral intervention
- Author Affiliations
- 1. Center for Health Sciences, SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025, USA
- 3. Free & Clear, Inc., 999 Third Avenue, Suite 2100, Seattle, WA, 98104, USA
- 4. Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30333, USA
- 2. Group Health Research Institute (formerly the Group Health Center for Health Studies), 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA