title: Cost-effectiveness of an intensive smoking cessation intervention for COPD outpatients.
abstract: BACKGROUND
  To determine the cost-effectiveness of a high-intensity smoking cessation program (SmokeStop Therapy; SST) versus a medium-intensity treatment (Minimal Intervention Strategy for Lung patients [LMIS]) for chronic obstructive pulmonary disease outpatients.
  
  
  METHODS
  The cost-effectiveness analysis was based on a randomized controlled trial investigating the effectiveness of the SST compared with the LMIS with 12-month follow-up. The primary outcome measure was the cotinine-validated continuous abstinence rate based on intention to treat. A health care perspective was adopted, with outcomes assessed in terms of (incremental) additional quitters gained, exacerbations prevented, and hospital days prevented. Health care resource use, associated with smoking cessation, was collected at baseline and 12 months after the start of the interventions. Monte Carlo simulations were performed to evaluate the robustness of the results.
  
  
  RESULTS
  The average patient receiving SST generated €581 in health care costs, including the costs of the smoking cessation program, versus €595 in the LMIS. The SST is also associated with a lower average number of exacerbations (0.38 vs. 0.60) and hospital days (0.39 vs. 1) per patient and a higher number of quitters (20 vs. 9) at lower total costs. This leads to a dominance of the SST compared with the LMIS.
  
  
  CONCLUSIONS
  The high-intensive SST is more cost-effective than the medium-intensive LMIS after 1 year. This is associated with cost savings per additional quitter, prevented exacerbations, and hospital days at lower or equal costs.
authors.affiliation: Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Lieke C A
authors.initials: LC
authors.lastname: Christenhusz
authors.forename: Rilana
authors.initials: R
authors.lastname: Prenger
authors.forename: Marcel E
authors.initials: ME
authors.lastname: Pieterse
authors.forename: Erwin R
authors.initials: ER
authors.lastname: Seydel
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
mesh_terms: D000328:Adult; D000368:Aged; D016642:Bupropion / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003367:Cotinine / Q000627:therapeutic use; D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000191:economics* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D010045:Outpatients / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control; D016540:Smoking Cessation / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D016642:Bupropion; D003367:Cotinine