Pfizer Oy, Helsinki, Finland.
Curr Med Res Opin. 2010 Mar;26(3):549-60. doi: 10.1185/03007990903542666.
To assess the cost effectiveness of varenicline compared with bupropion or unaided cessation for smoking cessation in Finnish adult smokers.
The BENESCO (BENEfits of Smoking Cessation on Outcomes) Markov model was used to follow a hypothetical cohort of smokers making a single quit attempt over a lifetime. Gender and age-specific data on the incidence and prevalence of five smoking-related diseases (chronic obstructive pulmonary disease [COPD], lung cancer, coronary heart disease [CHD], stroke and asthma exacerbations) were included in the model. Life-years (LYs), quality-adjusted life-years (QALYs), total treatment costs and the lifetime cumulative incidence of these parameters were the primary outcomes evaluated, and they were compared for varenicline versus bupropion and varenicline versus unaided cessation. The primary data were derived from Finnish publications and databases. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the base-case model.
The treatment cohort comprised 229 301 smokers making a quit attempt. In the lifetime simulation, use of varenicline prevented 1965 and 5057 additional cases of smoking-related disease, and 1184 and 3047 deaths attributable to smoking, when compared with bupropion and unaided cessation, respectively. Compared with bupropion and unaided cessation varenicline treatment yielded 4392 and 11 303 additional LYs (4851 and 12 485 QALYs), respectively. Varenicline resulted in cost savings of 15 million and 43 million euros (euro) compared with bupropion and unaided cessation, respectively. In the 20-year time horizon analysis, varenicline yielded an incremental cost-effectiveness ratio (ICER) of euro8791/QALY and euro7791/QALY gained in comparison to bupropion and unaided cessation, respectively. Sensitivity analyses supported the robustness of the base-case results for varenicline.
Varenicline dominated over its comparators, i.e. it was more effective and resulted in cost saving compared with bupropion and unaided cessation.
评估伐伦克林与安非他酮或单纯戒断相比，在芬兰成年吸烟者中的戒烟成本效果。
采用 BENESCO（戒烟对结局的益处）马尔可夫模型，对终生进行一次戒烟尝试的吸烟者进行假设队列随访。该模型纳入了与五种吸烟相关疾病（慢性阻塞性肺疾病[COPD]、肺癌、冠心病[CHD]、中风和哮喘恶化）的发生率和患病率相关的性别和年龄特异性数据。该研究的主要结果为生命年（LYs）、质量调整生命年（QALYs）、总治疗成本以及这些参数的终生累积发生率，并对伐伦克林与安非他酮、伐伦克林与单纯戒断进行了比较。原始数据来源于芬兰出版物和数据库。采用确定性和概率敏感性分析来检验基础模型的稳健性。
治疗队列包括 229301 名进行戒烟尝试的吸烟者。在终生模拟中，与安非他酮和单纯戒断相比，使用伐伦克林分别预防了 1965 例和 5057 例吸烟相关疾病，以及 1184 例和 3047 例归因于吸烟的死亡。与安非他酮和单纯戒断相比，伐伦克林治疗分别增加了 4392 例和 11303 例 LYs（4851 例和 12485 例 QALYs）。与安非他酮和单纯戒断相比，伐伦克林分别节省 1500 万欧元（欧元）和 4300 万欧元（欧元）的治疗成本。在 20 年时间范围内的分析中，与安非他酮和单纯戒断相比，伐伦克林的增量成本效益比（ICER）分别为 8791 欧元/QALY 和 7791 欧元/QALY。敏感性分析支持伐伦克林基础结果的稳健性。
伐伦克林优于其对照药物，即与安非他酮和单纯戒断相比，它更有效且具有成本效益。
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