Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians' smoking cessation counseling.
OBJECTIVE
To determine the incremental cost-effectiveness of the transdermal nicotine patch.


METHODS
Decision analytic model that evaluated the incremental cost-effectiveness of the addition of the nicotine patch to smoking cessation counseling. Costs were based on physician time and the retail cost of the nicotine patch, and benefits were based on quality-adjusted life years (QALYs) saved.


METHODS
Male and female smokers aged 25 to 69 years receiving primary care.


METHODS
Addition of the nicotine patch to physician-based smoking cessation counseling.


METHODS
Costs (1995 dollars) per QALYs save discounted by 3% annually.


RESULTS
The use of the patch produced 1 additional lifetime quitter at a cost of $7332. The incremental cost-effectiveness of the nicotine patch by age group ranged from $4390 to $10 943 per QALY for men and $4955 to $6983 per QALY for women. A clinical strategy involving limiting prescription renewals to patients successfully abstaining for the first 2 weeks improved the cost-effectiveness of the patch by 25%.


CONCLUSIONS
The findings provide support both for the routine use of the nicotine patch as an adjunct to physicians' smoking cessation counseling and for health insurance coverage of nicotine patch therapy.
Fiscella
K
K
Primary Care Institute, Highland Hospital, Rochester, NY, USA.
Franks
P
P
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D011320:Primary Health Care / Q000191:economics; D019057:Quality-Adjusted Life Years; D016540:Smoking Cessation / Q000191:economics / Q000379:methods; D014481:United States
D009538:Nicotine