Cost-utility analysis of smoking cessation to prevent operative complications following elective abdominal colon surgery - 06/12/18
Abstract |
Background |
Smoking is a known risk factor for postoperative complications after colectomy. Using the perspective of the provider, this study evaluated the cost-effectiveness of the pharmacologic interventions for smoking cessation.
Methods |
A decision tree model was constructed to represent a provider's decision to provide either bupropion, nicotine replacement therapy, varenicline, or no cessation therapy to all patients presenting for elective colectomy. Incremental cost per quality-adjusted life year (QALY) was the primary outcome.
Results |
The base case analysis suggests that bupropion is cost-effective with an incremental cost-effectiveness ratio of approximately $75,000 per QALY. Sensitivity analyses established ranges for which each medication might be cost-effective and dominant compared to offering no cessation therapy.
Conclusions |
From a provider perspective, offering bupropion for smoking cessation to patients scheduled for elective colon resection is cost-effective. Furthermore, these results provide benchmarks to inform providers about whether targeted, short-term smoking cessation therapies represent good value in colectomies.
Le texte complet de cet article est disponible en PDF.Highlights |
• | At baseline, bupropion therapy is cost-effective with an incremental cost-effectiveness ratio of approximately $75,000 per QALY. |
• | Reducing the cost of varenicline therapy to less than $143 per course results in varenicline being less costly and more effective than offering no smoking cessation therapy. |
• | Results provide thresholds to inform providers about whether uniformly providing targeted, short-term smoking cessation therapies to patients undergoing elective colectomy represents good value. |
Keywords : Smoking cessation, Operative complications, Colorectal surgery
Plan
Vol 216 - N° 6
P. 1082-1089 - décembre 2018 Retour au numéro
Article précédent
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