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Adv Ther. 2019 Feb;36(2):365-380. doi: 10.1007/s12325-018-0858-y. Epub 2018 Dec 19.

Healthcare Costs of Smokers Using Varenicline Versus Nicotine-Replacement Therapy Patch in the United States: Evidence from Real-World Practice.

Author information

1
Health Economics and Outcomes Research, Pfizer, Inc., New York, NY, USA. jiyoung.lee@pfizer.com.
2
Data Analytics, Evidera, Bethesda, MD, USA.
3
Medical Affairs, Pfizer, Inc., New York, NY, USA.
4
Statistical Research and Data Science Center, Pfizer, Inc., New York, NY, USA.
5
Health Economics and Outcomes Research, Pfizer, Inc., New York, NY, USA.

Abstract

INTRODUCTION:

Varenicline (VAR) is an effective smoking-cessation therapy compared to the commonly used nicotine-replacement therapy patch (NRT-P). However, comparative real-world evidence on smoking-cessation therapies is limited, especially for economic outcomes.

METHODS:

Using national claims databases (2012-2016) in the United States (US), adults initiating VAR or NRT-P without use of any other smoking-cessation products were followed for up to 1 year on a quarterly basis. Outcomes included smoking-attributable (SA) (cardiovascular, diabetes, pulmonary diseases, and smoking cessation) and all-cause costs (2017 US dollars). Adjusted mean costs were estimated from multivariable regressions, with baseline characteristics and propensity scores as covariates. Annual adjusted costs were calculated from quarterly averages.

RESULTS:

The VAR cohort (n = 209,284) was younger (mean age 46.7 vs. 49.0 years) and had fewer comorbidities [mean Charlson Comorbidity Index (CCI): 0.8 vs. 1.6] than the NRT-P cohort (n = 34,593). After adjustment, VAR cohort had lower SA and all-cause medical costs than NRT-P cohort in Quarters 1-4 (Q1-Q4) of follow-up, and had lower SA and all-cause total costs in Q2-Q4. Annually, VAR cohort had higher SA total costs ($307) and lower all-cause costs (- $2089) than NRT-P cohort. Annual medical costs were lower in VAR cohort (- $640 for SA and - $2876 for all-cause), and pharmacy costs were higher ($762 for SA and $777 for all-cause). In adherent patients (VAR: n = 38,744; NRT-P: n = 2702), VAR patients had lower annual medical costs (- $794 for SA and - $1636 for all-cause) and higher pharmacy costs ($1175 for SA and $1269 for all-cause); differences in SA and all-cause total costs were not statistically significant between treatment groups.

CONCLUSIONS:

Lower SA and all-cause medical costs associated with the use of VAR versus NRT-P resulted in savings in all-cause total costs and, among adherent patients, potentially offset the high pharmacy costs of VAR.

FUNDING:

Pfizer, Inc.

KEYWORDS:

Healthcare costs; Real-world evidence; Varenicline

PMID:
30569324
DOI:
10.1007/s12325-018-0858-y

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