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Open Access Green as soon as Postprint is submitted to ZB.
Cost-effectiveness of increasing the reach of smoking cessation interventions in Germany: Results from the EQUIPTMOD.
Addiction 113, 1, 52-64 (2018)
Aims
To evaluate costs, effects and cost‐effectiveness of increased reach of specific smoking cessation interventions in Germany.
Design
A Markov‐based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health‐care perspective (extended to include out‐of‐pocket payments) with life‐time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates.
Setting
Germany.
Participants
Cohort of current smoking population (18+ years) in Germany.
Interventions
Interventions included group‐based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group‐based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England.
Measurements
EQUIPTMOD considered reach, intervention cost, number of quitters, quality‐of‐life years (QALYs) gained, cost‐effectiveness and return on investment.
Findings
The highest returns through reduction in smoking‐related health‐care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group‐based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost‐savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return‐on‐investment estimates. At a hypothetical willingness‐to‐pay threshold of only €5000, the probability of being cost‐effective is approximately 75% for prospective scenario 1.
Conclusions
Increasing the reach of group‐based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost‐effective.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Behavioural Support ; Cost-effectiveness ; Equiptmod ; Germany ; Pharmacotherapy ; Policy ; Smoking Cessation; Polycyclic Aromatic-hydrocarbons; Lung Epithelial-cells; Yangtze-river Delta; 6 European Cities; Ambient Air; Oxidative Stress; Mouse Lung; A549 Cells; Cytotoxic Responses; Seasonal-variation
ISSN (print) / ISBN
0965-2140
e-ISSN
1360-0443
Journal
Addiction
Quellenangaben
Volume: 113,
Pages: 52-64,
Supplement: 1
Publisher
Wiley
Publishing Place
Oxford
Non-patent literature
Publications
Reviewing status
Peer reviewed