Cost-effectiveness of intensive smoking cessation therapy among patients with small abdominal aortic aneurysms
2011 (English)In: Journal of Vascular Investigation, ISSN 0741-5214, Vol. 54, no 3, 628-636 p.Article in journal (Refereed) Published
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.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-158870DOI: 10.1016/j.jvs.2011.02.055ISI: 000294505300004OAI: oai:DiVA.org:uu-158870DiVA: diva2:442102