Cost effectiveness of varenicline vs NRT in the UK
Enrico de Nigris, Outcome Research Manager, Pfizer, Tadworth, UK

Abstract

Background:
In the UK, smoking is by far the biggest single cause of preventable and chronic illness. Consequently, smoking drains the country of billions of pounds in health care costs and lost productivity each year.

Objective:
To describe the cost-effectiveness of varenicline, a drug for smoking cessation, compared with Nicotine Replacement Therapy (NRT; NiQuitin CQ Clear patch) using data from Aubin
et al.(2008) that showed efficacy continuous abstinence at 1 year of 26.1% for varenicline and 20.3 for NRT .

Methods:
We used a model that simulates a cohort of 3,000,000 smokers, actively wanting to quit, followed over a lifetime. At the end of each year, the members of the cohort are distributed into various smoking states, each of which can be associated with co-morbidities. Patients accumulate costs and outcomes through their transition to the different states, until they die.

Results:
In a lifetime, varenicline results in cost savings of
£284 million, from clinical events avoided. QALYs gained are 59,100.

Conclusions:
Modeled over a lifetime varenicline is both more clinically efficacious and cost saving. The cost savings are generated through the reduction in smoking related morbidity which more than offset the higher cost of varenicline.

Conflict of interest:
Enrico de Nigris is a Pfizer employee.