TY - JOUR
T1 - Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomised controlled trial
AU - Dawkins, Lynne
PY - 2020/2/11
Y1 - 2020/2/11
N2 - Aim
To evaluate the cost-effectiveness of e-cigarettes as a smoking cessation aid used in routine stop smoking service.
Design
Cost-effectiveness analysis was performed from the National Health Service (NHS) and Personal Social Services (PSS) perspective for 12 months period and lifetime. Costs, including that of both treatments, other smoking cessation help and healthcare services, and health benefits, estimated from EQ-5D-5L and measured in Quality-adjusted Life years (QALYs), for the 12-month analysis came from a randomised controlled trial. Lifetime analysis was model-based with input from both trial data and published secondary data sources. Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER).
Setting
Three English Stop-Smoking Service sites in England
Participants
Adult smokers who sought help to quit in the participating sites
Intervention and comparator
An e-cigarette (EC) starter kit versus provision of nicotine replacement therapy (NRT) for up to three months, both with standard behavioural support. A total of 886 participants were randomised (439 in EC arm, 447 in NRT arm). Excluding one death in each arm, the one-year quit rate was 18.0% and 9.9%, respectively.
Measurements
Cost of treatments was estimated from treatment log. Costs of other smoking cessation help and healthcare services, and EQ-5D-5L were collected at baseline, six- and 12-month follow-ups. Incremental costs and incremental QALYs were estimated using regression adjusting for baseline covariates and their respective baseline values.
Findings
The ICER was £1,100 per QALY gained at the 12 months after quit date (87% - 90% probability of cost-effective between £20,000/QALY and £30,000/QALY). Markov model estimated the lifetime ICER of EC to be £65 per QALY (around 85% probability of cost-effective between £20,000/QALY and £30,000/QALY).
Conclusion
Using e-cigarette as a smoking cessation aid with standard behavioural support in an English Stop-Smoking Service is more cost-effective than using nicotine replacement therapy in the same setting.
AB - Aim
To evaluate the cost-effectiveness of e-cigarettes as a smoking cessation aid used in routine stop smoking service.
Design
Cost-effectiveness analysis was performed from the National Health Service (NHS) and Personal Social Services (PSS) perspective for 12 months period and lifetime. Costs, including that of both treatments, other smoking cessation help and healthcare services, and health benefits, estimated from EQ-5D-5L and measured in Quality-adjusted Life years (QALYs), for the 12-month analysis came from a randomised controlled trial. Lifetime analysis was model-based with input from both trial data and published secondary data sources. Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER).
Setting
Three English Stop-Smoking Service sites in England
Participants
Adult smokers who sought help to quit in the participating sites
Intervention and comparator
An e-cigarette (EC) starter kit versus provision of nicotine replacement therapy (NRT) for up to three months, both with standard behavioural support. A total of 886 participants were randomised (439 in EC arm, 447 in NRT arm). Excluding one death in each arm, the one-year quit rate was 18.0% and 9.9%, respectively.
Measurements
Cost of treatments was estimated from treatment log. Costs of other smoking cessation help and healthcare services, and EQ-5D-5L were collected at baseline, six- and 12-month follow-ups. Incremental costs and incremental QALYs were estimated using regression adjusting for baseline covariates and their respective baseline values.
Findings
The ICER was £1,100 per QALY gained at the 12 months after quit date (87% - 90% probability of cost-effective between £20,000/QALY and £30,000/QALY). Markov model estimated the lifetime ICER of EC to be £65 per QALY (around 85% probability of cost-effective between £20,000/QALY and £30,000/QALY).
Conclusion
Using e-cigarette as a smoking cessation aid with standard behavioural support in an English Stop-Smoking Service is more cost-effective than using nicotine replacement therapy in the same setting.
U2 - 10.1111/add.14829
DO - 10.1111/add.14829
M3 - Article
SN - 0965-2140
SP - 507
EP - 517
JO - Addiction
JF - Addiction
ER -