Incremental cost-effectiveness of incorporating a smoking cessation intervention into a lung cancer screening program for selected smoking cessation scenarios*
| Smoking cessation intervention assumptions | ICER, $† | ||
|---|---|---|---|
| No discount | Discounted at 1.5% | Discounted at 3.0% | |
| Base case‡ | 15 700 | 22 200 | 30 400 |
| Quit rate per attempt | |||
| 10 attempts | |||
| 1% for 10 attempts | 50 100 | 67 900 | 90 000 |
| 5% for 10 attempts | 4700 | 7700 | 11 400 |
| 10% for 10 attempts | Dominant | 600 | 2200 |
| 2.5% for 5 attempts, then 1% for 5 attempts | 20 000 | 27 800 | 37 400 |
| 2.5% for 4 attempts, then 1% for 6 attempts | 22 200 | 30 600 | 41 000 |
| 5% for 5 attempts, then 1% for 5 attempts | 7500 | 11 200 | 15 800 |
| 5% for 4 attempts, then 1% for 6 attempts | 9000 | 13 100 | 18 300 |
| 3 attempts | |||
| 2.5% | 15 400 | 22 400 | 31 300 |
| 5% | 4600 | 7800 | 11 800 |
| 20 attempts | |||
| 2.5% for 5 attempts, then 1% for 15 attempts | 21 400 | 29 300 | 39 000 |
| 5% for 5 attempts, then 1% for 15 attempts | 8300 | 12 100 | 16 800 |
| Cessation intervention cost | |||
| 2.5% quit rate for 10 attempts | |||
| $252 per attempt (40% of base cost) | 3000 | 5000 | 8000 |
| $378 per attempt (60% of base cost) | 7000 | 10 800 | 15 000 |
| $756 per attempt (120% of base cost) | 20 000 | 28 000 | 38 000 |
| $945 per attempt (150% of base cost) | 26 000 | 36 600 | 49 000 |
| 2.5% quit rate for 5 attempts, then 1% for 5 attempts | |||
| $252 per attempt (40% of base cost) | 4400 | 7200 | 10 600 |
| $378 per attempt (60% of base cost) | 9600 | 14 000 | 19 500 |
| $756 per attempt (120% of base cost) | 25 200 | 34 600 | 46 300 |
| $945 per attempt (150% of base cost) | 33 000 | 44 900 | 59 600 |
| 5% quit rate for 10 attempts | |||
| $252 per attempt (40% of base cost) | Dominant | Dominant | 300 |
| $378 per attempt (60% of base cost) | 500 | 2000 | 4000 |
| $756 per attempt (120% of base cost) | 7000 | 11 000 | 15 000 |
| $945 per attempt (150% of base cost) | 10 000 | 15 000 | 21 000 |
| 5% quit rate for 5 attempts, then 1% for 5 attempts | |||
| $252 per attempt (40% of base cost) | Dominant | 500 | 2,000 |
| $378 per attempt (60% of base cost) | 2100 | 4100 | 6600 |
| $756 per attempt (120% of base cost) | 10 200 | 14 800 | 20 400 |
| $945 per attempt (150% of base cost) | 14 300 | 20 100 | 27 300 |
Note: ICER = incremental cost-effectiveness ratio.
↵* Annual screening of people aged 55–74 years with 30 pack-year or more smoking history, 40% recruitment rate phased in over 10 years and rescreening adherence rate of 70%. Unless stated otherwise, the base-case settings apply: cessation rate per attempt of 2.5% at a cost of $630 per attempt and maximum 10 attempts.
↵† Compared to screening with no smoking cessation intervention. Monte Carlo uncertainty leads to 95% confidence interval around ICERs of about ±3% on average.
↵‡ Cessation rate per attempt of 2.5% at cost of $630, maximum 10 attempts.