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The cost-effectiveness of the novel prescription smoking therapy varenicline in England and Wales
Enrico de Nigris, Outcome Research Manager, Pfizer
Abstract
To obtain recommendation of Varenicline in England and Wales, Pfizer UK Ltd was invited to submit clinical and cost effectiveness data for this therapy.
Varenicline (a 12 week course costing £165.6) was compared with both Nicotine Replacement Therapy (NRT) (Patch was chosen as it is the most commonly prescribed NRT in England and Wales, a 7 week course costing £117.6) and Bupropion (a 9 weeks course costing £ 81.5) over a life-time horizon. Efficacy was based on the confirmed quit rates at 1 year taken from pooling the results of the published clinical trials (Varenicline 22.5%, NRT 14.9% and Bupropion 15.7%).
The economic analysis was conducted using the BENESCO model (Benefits of Smoking Cessation in Outcomes) adapted from the HECOS model, which simulates morbidity and mortality over time in order to calculate the costs and benefits that accrue from smoking cessation.
In a life time, Cost savings of Varenicline are of £ 329 millions (Varenicline vs Bupropion), £ 494 millions (Varenicline vs NRT) and £ 589 millions (Varenicline vs Unaided Cessation). QALYs gained are 71400 for Vareicline vs Bupropion, 77,500 for Varenicline vs NRT and 133,000 for Varenicline vs unaided cessation.
Modeling the benefit of an additional 12 weeks course given to successful quitters vs successful quitters followed up results in 68,300 QALYs gained and cost savings of £ 163,200.
Varenicline dominated Bupropion, NRT and unaided cessation in a life time. Based on these data Varenicline should be accepted for use in England and Wales.
Biography
Enrico de Nigris in a Health Economist at Pfizer. After his Msc in Health Economics at the University of York, he worked four year at the university of Sheffield on Health Technology Assessments, guidelines and trial based economic evaluations and 1 year at the National collaborating centre for acute care, working alongside the cost effectiveness of the venous thromboembolism guideline, applying bayesian modeling to the complex network of mixed treatment comparisons. His interests are in the are of evidence synthesis, operational research, the treatment of missing data, and bayesian modeling.
Outcome Research Manager
Walton Oaks
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