Background. Smoking is the single most preventable cause of premature mortality in the United States. In 13 double-blind, controlled trials, the nicotine transdermal patch has been demonstrated to be an effective aid to quitting smoking, even after 6 months of follow-up. Because physicians and payers may consider the cost of the patch to be prohibitive, we examine the cost-effectiveness of the nicotine patch as an adjunct to brief physician counseling during routine office visits. Methods. We estimate the effectiveness of both patch use with brief counseling and counseling alone from meta-analysis of clinical trials. Benefits are measured in terms of years of life gained by those who quit, discounted at 5%. Costs include physician time and patch prescriptions. The incremental cost-effectiveness is quantified as cost per additional year of life saved when patch plus counseling is compared with brief physician counseling alone. Results. Depending on age, the average costs per year of life saved range from $965 to $1,585 for men and from $1,634 to $2,360 for women. Incremental costs per year of life saved range from $1,796 to $2,949 for men and from $3,040 to $4,391 for women. Conclusion. The nicotine patch is cost-effective and less costly per year of life saved than other widely accepted medical practices. Physicians and third-party payers should recommend the nicotine patch to patients who wish to stop smoking.
- cost-benefit analysis
- smoking cessation