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Applied Health Economics and Health Policy
Published in: Applied Health Economics and Health Policy 1/2016

Open Access 01-02-2016 | Original Research Article

Cost-Effectiveness Analysis of Smoking Cessation Interventions in Japan Using a Discrete-Event Simulation

Authors: Ataru Igarashi, Rei Goto, Kiyomi Suwa, Reiko Yoshikawa, Alexandra J. Ward, Jörgen Moller

Published in: Applied Health Economics and Health Policy | Issue 1/2016

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Abstract

Background

Smoking cessation medications have been shown to yield higher success rates and sustained abstinence than unassisted quit attempts. In Japan, the treatments available include nicotine replacement therapy (NRT) and varenicline; however, unassisted attempts to quit smoking remain common.

Objective

The objective of this study was to compare the health and economic consequences in Japan of using pharmacotherapy to support smoking cessation with unassisted attempts and the current mix of strategies used.

Methods

A discrete-event simulation that models lifetime quitting behaviour and includes multiple quit attempts (MQAs) and relapses was adapted for these analyses. The risk of developing smoking-related diseases is estimated based on the duration of abstinence. Data collected from a survey conducted in Japan were used to determine the interventions selected by smokers initiating a quit attempt and the time between MQAs. Direct and indirect costs are assessed (expressed in 2014 Japanese Yen).

Results

Using pharmacotherapy (NRT or varenicline) to support quit attempts proved to be dominant when compared with unassisted attempts or the current mix of strategies (most are unassisted). The results of stratified analyses by age imply that smoking cessation improves health outcomes across all generations. Indirect costs due to premature death leading to lost wages are an important component of the total costs, exceeding the direct medical cost estimates.

Conclusions

Increased utilisation of smoking cessation pharmacotherapy to support quit attempts is predicted to lead to an increase in the number of smokers achieving abstinence, and provide improvements in health outcomes over a lifetime with no additional costs.
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Metadata
Title
Cost-Effectiveness Analysis of Smoking Cessation Interventions in Japan Using a Discrete-Event Simulation
Authors
Ataru Igarashi
Rei Goto
Kiyomi Suwa
Reiko Yoshikawa
Alexandra J. Ward
Jörgen Moller
Publication date
01-02-2016
Publisher
Springer International Publishing
Published in
Applied Health Economics and Health Policy / Issue 1/2016
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI
https://doi.org/10.1007/s40258-015-0204-3

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