Presentation (CTI)

OBJECTIVES: To assess the cost-effectiveness of varenicline compared to bupropion for smoking cessation among adult smokers in the UK using a newly established cardiometabolic disease (CMD) policy model.
METHODS: The intervention evaluated in this case study is based on the Single Technology Appraisal (STA) published by NICE UK, which assessed the clinical and cost-effectiveness of varenicline for smoking cessation. The CMD policy model was applied and updated with relevant parameters to reflect this intervention. The analysis was conducted from the NHS and Personal Social Services (PSS) perspective, using a lifetime horizon, with a starting age of 40 years for smokers attempting to quit, and applying a 3.5% annual discount rate. Both deterministic and probabilistic sensitivity analyses were performed to assess model uncertainty.
RESULTS: Varenicline was more effective, yielding an additional 0.06 QALYs per person compared to bupropion. The estimated lifetime cost was £33,205 for varenicline versus £33,107 for bupropion. This resulted in an incremental cost-effectiveness ratio (ICER) of £1,656 per QALY gained, which is well below the UK cost-effectiveness threshold of £20,000-£30,000/QALY, indicating that varenicline is highly cost-effective from the NHS PSS perspective.At the population level, the estimated number of eligible adult smokers in England translated into a projected cumulative benefit of 63.92 million QALYs and a healthcare cost impact of approximately £135.79 billion over a lifetime horizon.
CONCLUSIONS: The CMD policy model demonstrates strong potential for conducting robust, long-term cost-effectiveness evaluations of smoking cessation interventions. These findings align with prior evidence and reinforce the value of varenicline as a cost-effective strategy for reducing smoking-related cardiometabolic risks in the UK population.