title: A systematic review of quality and cost-effectiveness derived from Markov models evaluating smoking cessation interventions in patients with chronic obstructive pulmonary disease.
abstract: Smoking cessation is the only strategy that has shown a lasting reduction in the decline of lung function in patients with chronic obstructive pulmonary disease. This study aims to evaluate the cost-effectiveness of smoking cessation interventions in patients with chronic obstructive pulmonary disease, to assess the quality of the Markov models and to estimate the consequences of model structure and input data on cost-effectiveness. A systematic literature search was conducted in PubMed, Embase, BusinessSourceComplete and Econlit on June 11, 2014. Data were extracted, and costs were inflated. Model quality was evaluated by a quality appraisal, and results were interpreted. Ten studies met the inclusion criteria. The results varied widely from cost savings to additional costs of €17,004 per quality adjusted life year. The models scored best in the category structure, followed by data and consistency. The quality of the models seems to rise over time, and regarding the results there is no economic reason to refuse the reimbursement of any smoking cessation intervention.
authors.affiliation: Munich School of Management and Munich Center of Health Sciences, Ludwig-Maximilians-University, Ludwigstr. 28 RG, 80539 Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Kirsch
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D006801:Humans; D008390:Markov Chains; D018803:Models, Economic; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D019057:Quality-Adjusted Life Years; D012051:Reimbursement Mechanisms / Q000191:economics; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*
keywords: Markov model; chronic obstructive pulmonary disease; cost–effectiveness; review; smoking cessation