College of Pharmacy, Catholic University of Korea, Bucheon, Gyeonggi-do, South Korea.
School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea.
Nicotine Tob Res. 2022 Nov 12;24(12):2011-2017. doi: 10.1093/ntr/ntac172.
Few studies have compared cost-effectiveness of different smoking cessation interventions (SCIs) that include behavioral support, considering smoking-related diseases. Therefore, we compare the cost-effectiveness of SCIs with behavioral support in South Korea using the Benefits of Smoking Cessation on Outcomes (BENESCO) model.
We used the BENESCO model to estimate the cost and utility of the SCIs with behavioral support, including pharmacist counseling with nicotine replacement therapy (pharmacist+NRT), expert counseling with NRT (expert+NRT), and expert counseling with varenicline (expert+varenicline). The target population was adult smokers who wanted to cease smoking within 1 month. We applied transitional probabilities and epidemiological data from the literature. Medical costs and utilities were calculated using claims and national survey data, respectively. Cost-effectiveness was evaluated within the threshold (17 926 USD per quality-adjusted life years [QALYs]) by incremental cost-effectiveness ratio (ICER).
The model cohort included 1 219 390 male and 298 511 female smokers. The pharmacist+NRT group had 32 842 more QALYs gained and 26 689 958 USD less expended than the expert+NRT group. The ICER for the expert+varenicline group versus the pharmacist+NRT and expert+NRT groups was 27 247 and 4074 USD per QALY, respectively. The robustness of the results was confirmed by sensitivity analyses, except for the discount rate and cost of the expert+varenicline group.
In Korea, pharmacist counseling with NRT showed higher QALY gains and lower costs than expert counseling with NRT. Expert counseling with varenicline was more effective for smoking cessation and more cost-effective than expert counseling with NRT but was not cost-effective compared with pharmacist counseling with NRT.
This study provides evidence for decision-making on smoking cessation programs by evaluating the cost-effectiveness of SCIs. Furthermore, we attempted to use the BENESCO model to compare and evaluate the cost-effectiveness of SCIs with behavioral support. It is meaningful because this study showed the availability of using the BENESCO model in the future cost-effectiveness analysis of various SCIs.
很少有研究比较包括行为支持在内的不同戒烟干预措施（SCIs）的成本效益，同时考虑到与吸烟相关的疾病。因此，我们使用 Benefits of Smoking Cessation on Outcomes（BENESCO）模型，比较了韩国具有行为支持的 SCIs 的成本效益。
我们使用 BENESCO 模型来估计具有行为支持的 SCIs 的成本和效用，包括药剂师咨询加尼古丁替代疗法（药剂师+NRT）、专家咨询加 NRT（专家+NRT）和专家咨询加伐尼克兰（专家+varenicline）。目标人群是希望在 1 个月内戒烟的成年吸烟者。我们应用了文献中的转移概率和流行病学数据。医疗成本和效用分别使用索赔和国家调查数据进行计算。通过增量成本效益比（ICER）在阈值（每质量调整生命年 17926 美元）内评估成本效益。
模型队列包括 1219390 名男性和 298511 名女性吸烟者。与专家+NRT 组相比，药剂师+NRT 组获得了 32842 个更多的 QALYs，并节省了 26689958 美元。与药剂师+NRT 和专家+NRT 组相比，专家+varenicline 组的 ICER 分别为每 QALY 27247 和 4074 美元。除了专家+varenicline 组的折扣率和成本外，敏感性分析证实了结果的稳健性。
在韩国，与专家咨询加 NRT 相比，药剂师咨询加 NRT 具有更高的 QALY 增益和更低的成本。与专家咨询加 NRT 相比，专家咨询加伐尼克兰对戒烟更有效且更具成本效益，但与药剂师咨询加 NRT 相比不具成本效益。
本研究通过评估 SCIs 的成本效益，为戒烟计划的决策提供了依据。此外，我们尝试使用 BENESCO 模型来比较和评估具有行为支持的 SCIs 的成本效益。这具有重要意义，因为本研究表明，在未来对各种 SCIs 的成本效益分析中，可以使用 BENESCO 模型。
