Economic evaluation of smoking-cessation therapies: a critical and systematic review of simulation models

Abstract

Background: Smoking is probably the most important among preventable health risks. Health economic evaluation of smoking-cessation interventions, applying a lifetime perspective, is made possible by available epidemiological knowledge. The well established method of performing cost-effectiveness analyses of smoking-cessation interventions involves mathematical modelling (both deterministic and stochastic) of future events important for cost effectiveness.

Objectives: This study surveys cost-effectiveness analyses of smoking cessation, with a particular focus on the mathematical modelling and simulation analyses performed.

Data sources: A systematic literature search was performed using the databases MEDLINE, Econlit and Academic Search Complete.

Study selection: Health economic evaluations, published as full-length journal articles, were searched for.

Results: 423 studies were identified and 78 were finally included, of which 30 were assessed as being highly relevant, based on the application of simulation modelling.

Conclusions: In general, studies are well performed as regards modelling. Common weaknesses include reporting of modelling details; validation of used simulation models; and the handling of structural uncertainty and different types of heterogeneity.