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Cost-effectiveness of intensive smoking cessation therapy among patients with small abdominal aortic aneurysms
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
2011 (English)In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 54, no 3, 628-636 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Smoking cessation is one of the few available strategies to decrease the risk for expansion and rupture of small abdominal aortic aneurysms (AAAs). The cost-effectiveness of an intensive smoking cessation therapy in patients with small AAAs identified at screening was evaluated. Methods: A Markov cohort simulation model was used to compare an 8-week smoking cessation intervention with adjuvant pharmacotherapy and annual revisits vs nonintervention among 65-year-old male smokers with a small AAA identified at screening. The smoking cessation rate was tested in one-way sensitivity analyses in the intervention group (range, 22%-57%) and in the nonintervention group (range, 3%-30%). Literature data on the effect of smoking on AAA expansion and rupture was factored into the model. Results: The intervention was cost-effective in all tested scenarios and sensitivity analyses. The smoking cessation intervention was cost-effective due to a decreased need for AAA repair and decreased rupture rate even when disregarding the positive effects of smoking cessation on long-term survival. The incremental cost/effectiveness ratio reached the willingness-to-pay threshold value of 25,000 per life-year gained when assuming an intervention cost of >(sic)3250 or an effect of <= 1% difference in long-term smoking cessation between the intervention and nonintervention groups. Smoking cessation resulted in a relative risk reduction for elective AAA repair by 9% and for rupture by 38% over 10 years of follow-up. Conclusions: An adequate smoking cessation intervention in patients with small AAAs identified at screening can cost-effectively increase long-term survival and decrease the need for AAA repair.

Place, publisher, year, edition, pages
2011. Vol. 54, no 3, 628-636 p.
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Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-158870DOI: 10.1016/j.jvs.2011.02.055ISI: 000294505300004OAI: oai:DiVA.org:uu-158870DiVA: diva2:442102
Available from: 2011-09-20 Created: 2011-09-19 Last updated: 2017-12-08Bibliographically approved

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Mani, KevinWanhainen, Anders

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