Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand

Tosanguan, Jiraboon and Chaiyakunapruk, Nathorn (2016) Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand. Addiction, 111 2: 340-350. doi:10.1111/add.13166


Author Tosanguan, Jiraboon
Chaiyakunapruk, Nathorn
Title Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand
Journal name Addiction   Check publisher's open access policy
ISSN 1360-0443
0965-2140
Publication date 2016-02-01
Year available 2015
Sub-type Article (original research)
DOI 10.1111/add.13166
Open Access Status Not Open Access
Volume 111
Issue 2
Start page 340
End page 350
Total pages 11
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Aims
Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand.

Methods
Using a Markov model, cost-effectiveness, in terms of cost per quality-adjusted life years (QALY) gained, from a range of interventions was estimated from a societal perspective for males and females aged 40 years who smoke at least 10 cigarettes per day. Interventions considered were: counselling in hospital, phone counselling (Quitline) and counselling plus nicotine gum, nicotine patch, bupropion, nortriptyline or varenicline. An annual discounting rate of 3% was used. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve (CEAC) plotted. Comparisons between interventions were conducted involving application of a ‘decision rule’ process.

Results
Counselling with varenicline and counselling with nortriptyline were found to be cost-effective. Hospital counselling only, nicotine patch and bupropion were dominated by Quitline, nortriptyline and varenicline, respectively, according to the decision rule. When compared with unassisted cessation, probabilistic sensitivity analysis revealed that all interventions have very high probabilities (95%) of being cost-saving except for nicotine replacement therapy (NRT) patch (74%).

Conclusion
In middle-income countries such as Thailand, nortriptyline and varenicline appear to provide cost-effective clinical options for supporting smokers to quit.
Keyword Bupropion
Cost-effectiveness
Cost-utility
Counselling
Nicotine gum
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published online 26 October 2015

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
 
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