Heron Evidence Development, Butterfield Technology and Business Park, Building 210A, Stopsley, Luton, LU2 8DL, UK.
Expert Opin Pharmacother. 2011 Dec;12(17):2613-26. doi: 10.1517/14656566.2011.628935. Epub 2011 Oct 21.
Smoking is an important risk factor in chronic obstructive pulmonary disease (COPD). A recent clinical trial demonstrated the efficacy of varenicline versus placebo as an aid to smoking cessation in patients with COPD. This study examines the cost-effectiveness of varenicline from the perspective of the healthcare systems of Spain (base case), the UK, France, Germany, Greece and Italy.
A Markov model was developed to determine the cost-effectiveness of varenicline as an aid to smoking cessation, compared to a placebo, in a COPD population. Cost-effectiveness was determined by the incremental cost per quality-adjusted life year (QALY) gained.
In the Spanish base case varenicline had an incremental cost of €1021/person for an average of 0.24 life years (0.17 QALYs), gained over the lifetime of a cohort of COPD patients, resulting in an incremental cost-effectiveness ratio (ICER) of €5,566. In the other European countries, the ICER varied between €4,519 (UK) and €10,167 (Italy). Probabilistic sensitivity analysis suggested varenicline had a high probability (>95%) of being cost-effective at a threshold of €30,000/QALY.
Varenicline is expected to be a cost-effective aid to smoking cessation in COPD patients in all of the countries studied.
吸烟是慢性阻塞性肺疾病（COPD）的一个重要危险因素。最近的一项临床试验表明，伐尼克兰在 COPD 患者中的戒烟辅助治疗效果优于安慰剂。本研究从西班牙（基础情况）、英国、法国、德国、希腊和意大利的医疗保健系统角度，考察了伐尼克兰的成本效益。
采用 Markov 模型，比较了 COPD 人群中作为戒烟辅助治疗的伐尼克兰与安慰剂的成本效益。通过增量成本效益比（ICER）来确定成本效益，即每获得一个质量调整生命年（QALY）所增加的成本。
在西班牙的基础情况下，与安慰剂相比，伐尼克兰的人均增量成本为 1021 欧元，可获得 0.24 个生命年（0.17 个 QALY），这是 COPD 患者队列终生的增量，导致增量成本效益比（ICER）为 5566 欧元。在其他欧洲国家，ICER 从英国的 4519 欧元到意大利的 10167 欧元不等。概率敏感性分析表明，伐尼克兰在阈值为 30000 欧元/QALY 时，有很高的可能性（>95%）具有成本效益。
在所有研究的国家中，伐尼克兰有望成为 COPD 患者戒烟的一种具有成本效益的辅助治疗方法。
