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

SummaryStudy objectivesTo 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.DesignThe 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.SettingSweden in 2003.Patients or participantsModel 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.InterventionsVarenicline as compared to bupropion, in smoking-cessation programmes for 20-year, 50-year, and lifetime follow-up periods.Measurements and resultsWhen the indirect effects on production and consumption were included, the incremental costs per QALY gained were €2056 (€14,743) for men and €1193 (€14,214) for women, in comparison to bupropion and computed for a time horizon of 20 and 50 years (1€≈€SEK9.12). 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.ConclusionsEstimated costs per QALY gained rated smoking-cessation intervention using varenicline among the most cost-effective life-saving medical treatments.