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Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta-analysis of economic evaluation studies.
Chaisai, Chayutthaphong; Patikorn, Chanthawat; Thavorn, Kednapa; Lee, Shaun Wen Huey; Chaiyakunapruk, Nathorn; Veettil, Sajesh K.
Afiliación
  • Chaisai C; School of Pharmacy, Monash University Malaysia, Selangor, Malaysia.
  • Patikorn C; Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.
  • Thavorn K; Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, USA.
  • Lee SWH; Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
  • Chaiyakunapruk N; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
  • Veettil SK; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Addiction ; 119(7): 1188-1202, 2024 07.
Article en En | MEDLINE | ID: mdl-38520121
ABSTRACT

AIMS:

To conduct a systematic review and meta-analysis and pool the incremental net benefits (INBs) of varenicline compared with behaviour support with bupropion or nicotine replacement therapy (NRT), behaviour support alone and unaided cessation in adult smokers making a first-time attempt to quit.

METHODS:

A search for economic evaluation studies was conducted from inception to 30 September 2022, on PubMed, Embase, Cost-Effectiveness Analysis (CEA) Registry by Tufts Medical Centre, EconLit and the NHS Economic Evaluation Database (NHS EED). Eligible studies were included if they were (1) conducted among adults ages 18 years old and older who were smokers attempting to quit for the first time; (2) compared varenicline to behaviour support with bupropion or NRT, behaviour support alone and unaided cessation; and (3) performed a CEA or cost-utility analysis. The INBs were calculated and pooled across studies stratified by country income level and study perspective using the random-effects model. Statistical heterogeneity between studies was assessed using the I2 statistic and Cochrane Q statistic.

RESULTS:

Of the 1433 identified studies, 18 studies were included in our review. Our findings from healthcare system/payer perspective suggested that the use of varenicline is statistically significantly cost-effective compared with bupropion (pooled INB, $830.75 [95% confidence interval, $208.23, $1453.28]), NRTs ($636.16 [$192.48, $1079.84]) and unaided cessation ($4212.35 [$1755.79, $6668.92]) in high-income countries. Similarly, varenicline is also found to be cost-effective compared to bupropion ($2706.27 [$1284.44, $4128.11]), NRTs ($3310.01 [$1781.53, $4838.50]) and behavioural support alone ($5438.22 [$4105.99, $6770.46]) in low- and middle-income countries.

CONCLUSION:

Varenicline is cost-effective as a smoking cessation aid when compared with behavioural support with bupropion or nicotine replacement therapies and behavioural support alone in both high-income countries and low- and middle-income countries, from the healthcare system/payer perspective in adult smokers who attempt to quit for the first time.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cese del Hábito de Fumar / Bupropión / Análisis Costo-Beneficio / Vareniclina / Agentes para el Cese del Hábito de Fumar Límite: Adult / Humans Idioma: En Revista: Addiction Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cese del Hábito de Fumar / Bupropión / Análisis Costo-Beneficio / Vareniclina / Agentes para el Cese del Hábito de Fumar Límite: Adult / Humans Idioma: En Revista: Addiction Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Reino Unido