Varenicline as compared to bupropion in smoking-cessation therapy-Cost-utility results for Sweden 2003.

STUDY OBJECTIVES: To calculate incremental cost-utility ratios (cost per QALY gained) for varenicline (Champix; Pfizer), as compared to bupropion, in smoking-cessation programmes for a lifetime follow-up period. DESIGN: The Benefits of Smoking Cessation on Outcomes (BENESCO) simulation model was used for a male and female cohort, respectively, as a point of departure but further extended in order to include the indirect effects of smoking-cessation on production and consumption in the economy. All calculations were performed in 2003 Swedish prices. SETTING: Sweden in 2003. PATIENTS OR PARTICIPANTS: Model cohort consisting of 25% of all smokers among men and women (168,844 males and 208,737 females), distributed by age, 18 and older, as in the Swedish population of 2003. INTERVENTIONS: Varenicline as compared to bupropion, in smoking-cessation programmes for 20-year, 50-year, and lifetime follow-up periods. MEASUREMENTS AND RESULTS: When the indirect effects on production and consumption were included, the incremental costs per QALY gained were euro2056 (euro14,743) for men and euro1193 (euro14,214) for women, in comparison to bupropion and computed for a time horizon of 20 and 50 years (1euro approximately euroSEK9.12). Excluding the indirect effects on production and consumption, varenicline was cost-saving in comparison to bupropion. Sensitivity analysis indicated that the results are robust. Variation of treatment efficiency and intervention costs, respectively, had a larger effect on cost per QALY gained than other variables. CONCLUSIONS: Estimated costs per QALY gained rated smoking-cessation intervention using varenicline among the most cost-effective life-saving medical treatments