Objectives

The SMART Quit Clinic Program (FAHSAI Clinic) offered by a multidisciplinary health team has been implemented in Thailand since 2010; however, it remains unclear whether the benefits gained from this program justify its costs. We assessed the cost-effectiveness of this program compared to usual care in a population of Thai smokers with cardiovascular disease (CVD) from a societal perspective.

Methods

We conducted a cost-utility analysis using a Markov model to simulate the lifetime costs and QALYs for patients aged ≥ 35 years receiving smoking cessation services from either FAHSAI Clinic or usual care over a horizon of 50 years. The model used continuous abstinence rates (CAR) at 6 months that were obtained from a multicenter prospective observational study of 24 FAHSAI clinics across 21 provinces of Thailand. Other input parameters, including cost and utility data, were obtained from targeted literature searches. A series of sensitivity analyses including probabilistic sensitivity analysis were conducted to assess robustness of study findings. The results were presented in 2020 US Dollars (USD).

Results

In the base case analysis, the FAHSAI Clinic was dominant as it was less costly ($9,537.92 vs. $10,964.19) and more effective (6.06 vs. 5.96 QALYs) as compared with usual care over the 50-year time horizon. Changes in the risk of coronary heart disease among males had the largest impact on the cost-effectiveness findings. The probability that FAHSAI clinic was cost-effective was 100% regardless of the willingness to pay (WTP) value.

Conclusion

The FAHSAI clinic smoking cessation program was cost-effective as it was clinically superior and cost-saving compared to usual care for Thai patients with CVD. A budget impact analysis is needed to estimate the financial impact of the adopting this program within the Thai healthcare system.