延长伐尼克兰疗程（12 + 12周）与其它可用的戒烟措施相比的戒烟成本－效益：美国BENESCO模式的扩展与更新
2010/02/23
目的：该研究旨在使用BENESCO （戒烟对转归的收益）戒烟模型评价延长伐尼克兰使疗程（12+12周）的成本－效益。
方法：通过与混合治疗对比，分析12＋12周伐尼克兰辅助戒烟的有效性数据，并结合以前BENESCO 模型中涉及的12周伐尼克兰、12周安非他酮和安慰剂戒烟的有效性数据。本研究对上述干预措施在戒烟中的有效性进行了更新，并以此为依据建立模型确定上述干预措施，包括12＋12周伐尼克兰戒烟的成本－效益比。
结果：12＋12周伐尼克兰、12周的伐尼克兰、12周安非他酮和12周安慰剂治疗基于混合治疗对比的1年戒断率分别为27.7%、22.9%、15.9%和9.3%。12＋12周伐尼克兰治疗估计（基于12周疗程+12周成功戒断）的平均费用支出为603.89美元。除12周伐尼克兰戒烟外，与其他戒烟措施相比，12＋12周伐尼克兰戒烟的费用较少，且有效性更高。在该比较研究中， 12＋12周伐尼克兰戒烟具有较好的成本－效益，也用于代替12周疗程戒烟，每获得一个质量调整生命年（QALY）其开支增加小于1000美元。
结论：与目前使用的其它戒烟措施相比，12＋12周伐尼克兰戒烟具有较好的成本-效益比。
（陈欣 审校）
Value Health. 2009 Nov 13. [Epub ahead of print]
The Cost-Effectiveness of an Extended Course (12 + 12 Weeks) of Varenicline Compared with Other Available Smoking Cessation Strategies in the United States: An Extension and Update to the BENESCO Model.
Knight C, Howard P, Baker CL, Marton JP.
ABSTRACT Objectives: This study aimed to estimate the cost-effectiveness of an extended (12 + 12 weeks) course of varenicline using the (Benefits of Smoking Cessation on Outcomes) BENESCO smoking cessation model.
Methods: Data on the efficacy of 12 + 12 weeks varenicline therapy in aiding smoking cessation were analyzed in conjunction with the efficacy data for 12 weeks of varenicline, bupropion, and placebo previously included in the BENESCO model, by using a mixed treatment comparison. This analysis provided updated efficacy estimates for all the interventions, and these were used to update the model to estimate the relative cost-effectiveness of all smoking cessation interventions considered, now including 12 + 12 weeks of varenicline.
Results: The updated 1-year abstinence estimates derived from the mixed treatment comparison were, for 12 + 12 weeks of varenicline, 12 weeks of varenicline, 12 weeks of bupropion, and 12 weeks of placebo, respectively: 27.7%, 22.9%, 15.9%, and 9.3%. The average cost of the course of 12 + 12 weeks of varenicline was estimated at $603.89, based on a 12-week course followed by a further 12 weeks for successful quitters. Over all subjects’ lifetimes, 12 + 12 weeks of varenicline is less costly and more effective than (dominates) all other strategies compared in the updated BENESCO model, with the exception of 12 weeks of varenicline. In this comparison, 12 + 12 weeks of varenicline is a very cost-effective alternative to the 12-week course, with an incremental cost of less than $1000 per quality-adjusted life year (QALY) gained.
Conclusions: A total of 12 weeks of varenicline followed by a further 12-week course for successful quitters is a highly cost-effective alternative compared with currently available smoking cessation options.
Knight C, Howard P, Baker CL, et al. Value Health. 2009 Nov 13. [Epub ahead of print]
方法：通过与混合治疗对比，分析12＋12周伐尼克兰辅助戒烟的有效性数据，并结合以前BENESCO 模型中涉及的12周伐尼克兰、12周安非他酮和安慰剂戒烟的有效性数据。本研究对上述干预措施在戒烟中的有效性进行了更新，并以此为依据建立模型确定上述干预措施，包括12＋12周伐尼克兰戒烟的成本－效益比。
结果：12＋12周伐尼克兰、12周的伐尼克兰、12周安非他酮和12周安慰剂治疗基于混合治疗对比的1年戒断率分别为27.7%、22.9%、15.9%和9.3%。12＋12周伐尼克兰治疗估计（基于12周疗程+12周成功戒断）的平均费用支出为603.89美元。除12周伐尼克兰戒烟外，与其他戒烟措施相比，12＋12周伐尼克兰戒烟的费用较少，且有效性更高。在该比较研究中， 12＋12周伐尼克兰戒烟具有较好的成本－效益，也用于代替12周疗程戒烟，每获得一个质量调整生命年（QALY）其开支增加小于1000美元。
结论：与目前使用的其它戒烟措施相比，12＋12周伐尼克兰戒烟具有较好的成本-效益比。
（陈欣 审校）
Value Health. 2009 Nov 13. [Epub ahead of print]
The Cost-Effectiveness of an Extended Course (12 + 12 Weeks) of Varenicline Compared with Other Available Smoking Cessation Strategies in the United States: An Extension and Update to the BENESCO Model.
Knight C, Howard P, Baker CL, Marton JP.
ABSTRACT Objectives: This study aimed to estimate the cost-effectiveness of an extended (12 + 12 weeks) course of varenicline using the (Benefits of Smoking Cessation on Outcomes) BENESCO smoking cessation model.
Methods: Data on the efficacy of 12 + 12 weeks varenicline therapy in aiding smoking cessation were analyzed in conjunction with the efficacy data for 12 weeks of varenicline, bupropion, and placebo previously included in the BENESCO model, by using a mixed treatment comparison. This analysis provided updated efficacy estimates for all the interventions, and these were used to update the model to estimate the relative cost-effectiveness of all smoking cessation interventions considered, now including 12 + 12 weeks of varenicline.
Results: The updated 1-year abstinence estimates derived from the mixed treatment comparison were, for 12 + 12 weeks of varenicline, 12 weeks of varenicline, 12 weeks of bupropion, and 12 weeks of placebo, respectively: 27.7%, 22.9%, 15.9%, and 9.3%. The average cost of the course of 12 + 12 weeks of varenicline was estimated at $603.89, based on a 12-week course followed by a further 12 weeks for successful quitters. Over all subjects’ lifetimes, 12 + 12 weeks of varenicline is less costly and more effective than (dominates) all other strategies compared in the updated BENESCO model, with the exception of 12 weeks of varenicline. In this comparison, 12 + 12 weeks of varenicline is a very cost-effective alternative to the 12-week course, with an incremental cost of less than $1000 per quality-adjusted life year (QALY) gained.
Conclusions: A total of 12 weeks of varenicline followed by a further 12-week course for successful quitters is a highly cost-effective alternative compared with currently available smoking cessation options.
Knight C, Howard P, Baker CL, et al. Value Health. 2009 Nov 13. [Epub ahead of print]
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