1. Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD.
- Author
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Huber, Manuel B., Präger, Maximilian, Coyle, Kathryn, Coyle, Doug, Lester‐George, Adam, Trapero‐Bertran, Marta, Nemeth, Bertalan, Cheung, Kei Long, Stark, Renee, Vogl, Matthias, Pokhrel, Subhash, and Leidl, Reiner
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COST effectiveness , *SMOKING cessation , *RATE of return , *MARKOV processes , *MEDICAL care , *PROBABILITY theory , *VARENICLINE , *ECONOMICS , *THERAPEUTICS , *DISEASE risk factors , *SOCIAL support , *CONFIDENCE intervals , *RESEARCH funding , *DATA analysis software , *DESCRIPTIVE statistics ,HUMAN behavior & society - Abstract
Abstract: Aims: To evaluate costs, effects and cost‐effectiveness of increased reach of specific smoking cessation interventions in Germany. Design: A Markov‐based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health‐care perspective (extended to include out‐of‐pocket payments) with life‐time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates. Setting: Germany. Participants: Cohort of current smoking population (18+ years) in Germany. Interventions: Interventions included group‐based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group‐based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England. Measurements: EQUIPTMOD considered reach, intervention cost, number of quitters, quality‐of‐life years (QALYs) gained, cost‐effectiveness and return on investment. Findings: The highest returns through reduction in smoking‐related health‐care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group‐based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost‐savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return‐on‐investment estimates. At a hypothetical willingness‐to‐pay threshold of only €5000, the probability of being cost‐effective is approximately 75% for prospective scenario 1. Conclusions: Increasing the reach of group‐based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost‐effective. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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