The cost-effectiveness of antidepressants for smoking cessation in chronic obstructive pulmonary disease (COPD) patients

Addiction
Constant P van SchayckJohannes L Severens

Abstract

In healthy smokers, antidepressants can double the odds of cessation. Because of its four times lower costs and comparable efficacy in healthy smokers, nortriptyline appears to be favourable compared to bupropion. We assessed which of both drugs was most effective and cost-effective in stopping smoking after 1 year compared with placebo among smokers at risk or with existing chronic obstructive pulmonary disease (COPD). A total of 255 participants, aged 30-70 years, received smoking cessation counselling and were assigned bupropion, nortriptyline or placebo randomly for 12 weeks. Prolonged abstinence from smoking was defined as a participant's report of no cigarettes from week 4 to week 52, validated by urinary cotinine. Costs were calculated using a societal perspective and uncertainty was assessed using the bootstrap method. The prolonged abstinence rate was 20.9% with bupropion, 20.0% with nortriptyline and 13.5% with placebo. The differences between bupropion and placebo [relative risk (RR) = 1.6; 95% confidence interval (CI) 0.8-3.0] and between nortriptyline and placebo (RR = 1.5; 95% CI 0.8-2.9) were not significant. Severity of airway obstruction did not influence abstinence significantly. Societal costs were 1368 euros...Continue Reading

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Citations

Dec 20, 2011·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Lieke C A ChristenhuszJob van der Palen
Apr 12, 2011·CNS Drugs·Tobias Raupach, Constant P van Schayck
Nov 13, 2014·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Jesse KigoziJoanna Coast
Dec 17, 2014·Revue des maladies respiratoires·M UndernerG Peiffer
Sep 13, 2016·American Journal of Preventive Medicine·Sarah B WindleMark J Eisenberg
Nov 3, 2011·JRSM Short Reports·Sophie Coronini-CronbergMichael Robinson
Aug 23, 2016·The Cochrane Database of Systematic Reviews·Eva A M van EerdDaniel Kotz
Jan 10, 2014·The Cochrane Database of Systematic Reviews·John R HughesTim Lancaster
Apr 18, 2015·The European Respiratory Journal·Carlos A Jiménez-RuizChristina Gratziou
Jul 19, 2019·Interactive Cardiovascular and Thoracic Surgery·Akihiro NagoyaMeinoshin Okumura
Apr 23, 2020·The Cochrane Database of Systematic Reviews·Seth HowesNicola Lindson
May 12, 2018·Revue de pneumologie clinique·J PerriotB Dautzenberg

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