Cost-Utility Analysis of Varenicline, an Oral Smoking-Cessation Drug, in Japan
- PDF / 205,084 Bytes
- 15 Pages / 505 x 720 pts Page_size
- 18 Downloads / 156 Views
ORIGINAL RESEARCH ARTICLE
ยช 2009 Adis Data Information BV. All rights reserved.
Cost-Utility Analysis of Varenicline, an Oral Smoking-Cessation Drug, in Japan Ataru Igarashi,1 Hiroki Takuma,2 Takashi Fukuda3 and Kiichiro Tsutani1 1 Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan 2 Research Unit of Social and Administrative Pharmacy Science, College of Pharmacy, Nihon University, Chiba, Japan 3 Department of Health Economics and Epidemiology Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Abstract
Objectives: To conduct a cost-utility analysis of two 12-week smoking-cessation interventions in Japan: smoking-cessation counselling by a physician compared with use of varenicline, an oral smoking-cessation drug, in addition to counselling. Methods: A Markov model was constructed to analyse lifetime medical costs and QALYs from the perspective of the healthcare payer. The cycle length was 5 years. Both costs and QALYs were discounted at 3% annually. The cohort of smokers was classified by sex and age, and we assumed that smokers started smoking at the age of 20 years and received smoking-cessation therapy at the ages of 30, 40, 50, 60 or 70 years (five separate models were run). The healthcare costs and QALYs were calculated throughout the term until the age of 90 years. In the base-case analysis, success rates of varenicline plus counselling and counselling alone were assumed to be 37.9% and 25.5%, respectively, in male smokers, and 22.2% and 16.1%, respectively, in female smokers, based on a randomized controlled trial conducted in Japan. Both univariate and probabilistic sensitivity analyses were conducted. Results: Prescribed varenicline was shown to be more effective and less costly than smoking-cessation counselling alone. Varenicline would save direct medical costs of Japanese Yen (f)43 846 ($US381; $US1 = f115; Oct 2007) and generate an increase of 0.094 QALYs in male smokers. In females the incremental costeffectiveness ratio was f346 143 per QALY gained. Varenicline is estimated to save f23.7 billion ($US206 million) of the medical costs for tobacco-associated diseases for the whole population. Overall savings are f9.5 billion. Sensitivity analyses suggested the robustness of the results. Conclusion: As with any data of this nature, there is some uncertainty in the results and further research is warranted. However, based on the results of this pharmacoeconomic evaluation, varenicline, the first non-nicotine, oral treatment
Igarashi et al.
248
developed for smoking cessation, appears to be cost effective and may contribute to future medical cost savings in Japan.
Background Japan is lagging behind other developed countries with respect to its anti-tobacco policy. The prevalence of smoking in Japan is gradually decreasing. However, it remains higher[1] than other developed countries such as the US (19.1%), UK (25.0%) and Germany (29.8%),[2] particularly for males (39.3%). People in their thirties hav
Data Loading...
