Cost-effectiveness of possible future smoking cessation strategies in Hungary: results from the EQUIPTMOD

Abstract

AIMS To evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary. METHODS The EQUIPTMOD, a Markov-based economic model was used to assess the cost-effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group-based behavioral support therapies and pro-active telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with the current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Lifetime costs and quality-adjusted life years (QALYs) were calculated from a healthcare perspective. The analyses used various return on investment (ROI) estimates, including incremental cost-effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values. RESULTS Introducing a social marketing campaign resulted in an increase of 30 additional quitters per 100,000 smokers, translating to healthcare cost-savings of €0.65 per smoker compared with the current practice. When the value of QALY gains was considered, cost-savings increased to €14 per smoker. Doubling the reach of existing group-based behavioral support therapies and pro-active telephone support resulted in healthcare savings of €0.25 per smoker (€3.96 with the value of QALY gains), compared with the current practice. The respective figures for the combined scenario were: €0.90 and €18. Results were sensitive to model input values. CONCLUSIONS According to the EQUIPTMOD modelling tool it would be cost-effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group-based behavioural support therapies and pro-active telephone support. Such policies would more than pay for themselves in the long run.