OBJECTIVES: Smoking cessation interventions lower the risks of serious health problems and mortality and save the health system money. The national, multidisciplinary smoking cessation clinics have been founded in Thailand since 2010; however, their cost-effectiveness for patients with Chronic Obstructive Pulmonary Disease (COPD) has never been formally evaluated. This study aimed to assess the cost-effectiveness of these multidisciplinary clinics compared to usual care among patients with COPD in Thailand from a societal perspective.

METHODS: We conducted a cost-utility analysis and developed a Markov model encompassing six-health states to simulate lifetime costs and quality-adjusted life years (QALYs) of each smoking cessation intervention over the patient lifetime. The model also included two sub-models for current and former smokers. We derived the effectiveness of the smoking cessation clinics from a multicenter, longitudinal study of smoking cessation services across Thailand. We sought the natural quit rate, transition probabilities, health utility and cost data from the published literature. All future costs and outcomes were discounted at an annual rate of 3%. A series of sensitivity analyses was performed.

RESULTS: Compared to usual care, the national, multidisciplinary smoking cessation clinics were associated with higher costs and improved QALYs, with an ICER of 46,623.37 THB/QALY (1,469.19 US$/QALY). The efficacy of the national smoking cessation services was a key driver of the cost-effectiveness results. Results from the probabilistic sensitivity analysis showed the probability that the clinics are cost-effective at a willingness-to-pay (WTP) threshold of 160,000 THB (50,41.91 US$) was 97.7%.

CONCLUSIONS: The national, multidisciplinary smoking cessation clinics were cost-effective at the Thai WTP threshold of 160,000 THB/QALY due to their ability to reduce future smoking-related morbidity and mortality among COPD patients. Our results could assist health policy decision-makers in allocating resources to support smoking cessation services in Thailand.