TY - JOUR
T1 - Cost-effectiveness of pharmacogenetic testing to tailor smoking-cessation treatment
AU - Heitjan, D. F.
AU - Asch, D. A.
AU - Ray, Riju
AU - Rukstalis, Margaret
AU - Patterson, Freda
AU - Lerman, C.
N1 - Funding Information:
We acknowledge the contributions of the following investigators to the pharmacogenetic studies on which this analysis was based: Wade H Berrettini, Susan Crystal-Mansour, Leonard Epstein, Larry Hawk, Vyga Kaufmann, David Main, Ray Niaura, Angela Pinto, Peter Shields, Susan Ware and E Paul Wileyto. We also thank Steven Siegel for helpful comments on an earlier draft. Sources of funding: This study was supported by Grants P50 CA084718 from the National Cancer Institute and National Institutes on Drug Abuse and R01 CA063562 from the National Cancer Institute, which had no role in its design, conduct or reporting.
PY - 2008
Y1 - 2008
N2 - We evaluated the cost-effectiveness of a range of smoking cessation drug treatments, including varenicline, transdermal nicotine (TN), bupropion and the use of a genetic test to choose between TN and bupropion. We performed Monte Carlo simulation with sensitivity analysis, informing analyses with published estimates of model parameters and current prices for genetic testing and smoking-cessation therapy. The primary outcomes were discounted life-years (LY) and lifetime tobacco-cessation treatment costs. In the base case, varenicline treatment was optimal with an ICER, compared to bupropion, of $2985/LY saved. In sensitivity analyses, varenicline was in all cases (and bupropion in most cases) admissible; only under favorable assumptions was the genetically tailored approach competitive. Our data suggest that an untailored approach of treatment with either bupropion or varenicline is a cost-effective form of tobacco dependence treatment, but a tailored approach for selecting between TN and bupropion can be cost-effective under plausible assumptions.
AB - We evaluated the cost-effectiveness of a range of smoking cessation drug treatments, including varenicline, transdermal nicotine (TN), bupropion and the use of a genetic test to choose between TN and bupropion. We performed Monte Carlo simulation with sensitivity analysis, informing analyses with published estimates of model parameters and current prices for genetic testing and smoking-cessation therapy. The primary outcomes were discounted life-years (LY) and lifetime tobacco-cessation treatment costs. In the base case, varenicline treatment was optimal with an ICER, compared to bupropion, of $2985/LY saved. In sensitivity analyses, varenicline was in all cases (and bupropion in most cases) admissible; only under favorable assumptions was the genetically tailored approach competitive. Our data suggest that an untailored approach of treatment with either bupropion or varenicline is a cost-effective form of tobacco dependence treatment, but a tailored approach for selecting between TN and bupropion can be cost-effective under plausible assumptions.
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U2 - 10.1038/sj.tpj.6500492
DO - 10.1038/sj.tpj.6500492
M3 - Article
C2 - 18347612
AN - SCOPUS:56349111039
SN - 1470-269X
VL - 8
SP - 391
EP - 399
JO - Pharmacogenomics Journal
JF - Pharmacogenomics Journal
IS - 6
ER -