Within a smoking-cessation program, what impact does genetic information on lung cancer need to have to demonstrate cost-effectiveness?

File Size Format
67344_1.pdf 423Kb Adobe PDF View
Title Within a smoking-cessation program, what impact does genetic information on lung cancer need to have to demonstrate cost-effectiveness?
Author Gordon, Louisa; Hirst, Nicholas G; Young, Robert P; Brown, Paul M
Journal Name Cost Effectiveness and Resource Allocation
Year Published 2010
Place of publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background Many smoking-cessation programs and pharmaceutical aids demonstrate substantial health gains for a relatively low allocation of resources. Genetic information represents a type of individualized or personal feedback regarding the risk of developing lung cancer, and hence the potential benefits from stopping smoking, may motivate the person to remain smoke-free. The purpose of this study was to explore what the impact of a genetic test needs to have within a typical smoking-cessation program aimed at heavy smokers in order to be cost-effective. Methods Two strategies were modelled for a hypothetical cohort of heavy smokers aged 50 years; individuals either received or did not receive a genetic test within the course of a usual smoking-cessation intervention comprising nicotine replacement therapy (NRT) and counselling. A Markov model was constructed using evidence from published randomized controlled trials and meta-analyses for estimates on 12-month quit rates and long-term relapse rates. Epidemiological data were used for estimates on lung cancer risk stratified by time since quitting and smoking patterns. Extensive sensitivity analyses were used to explore parameter uncertainty. Results The discounted incremental cost per QALY was AU$34,687 (95% CI $12,483, $87,734) over 35 years. At a willingness-to-pay of AU$20,000 per QALY gained, the genetic testing strategy needs to produce a 12-month quit rate of at least 12.4% or a relapse rate 12% lower than NRT and counselling alone for it to be equally cost-effective. The likelihood that adding a genetic test to the usual smoking-cessation intervention is cost-effective was 20.6% however cost-effectiveness ratios were favourable in certain situations (e.g., applied to men only, a 60 year old cohort). Conclusions The findings were sensitive to small changes in critical variables such as the 12-month quit rates and relapse rates. As such, the cost-effectiveness of the genetic testing smoking cessation program is uncertain. Further clinical research on smoking-cessation quit and relapse rates following genetic testing is needed to inform its cost-effectiveness.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1186/1478-7547-8-18
Copyright Statement Copyright 2010 Gordon et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Volume 8
Page from 1
Page to 10
ISSN 1478-7547
Date Accessioned 2011-01-27
Language en_AU
Comments Page numbers are not for citation purposes. Instead, this article has the unique article number of 2010 8:18.
Research Centre Population and Social Health Research Program
Faculty Griffith Health Faculty
Subject Medical and Health Sciences
URI http://hdl.handle.net/10072/36149
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

Show simple item record

Griffith University copyright notice