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Cost-effectiveness of smoking cessation to prevent age-related macular degeneration.

Hurley SF, Matthews JP, Guymer RH - Cost Eff Resour Alloc (2008)

Bottom Line: Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk.Cost-effectiveness ratios were based on the cost of the Massachusetts Tobacco Control Program.Macular degeneration-related costs would decrease by $2.5 million if the costs of caregivers for people with vision loss were included, or by $1.1 million if caregiver costs were excluded.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bainbridge Consultants, 222/299 Queen St, Melbourne, VIC 3000, Australia. susanhurley@bainbridgeconsultants.com

ABSTRACT

Background: Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk.

Methods: We fitted a function predicting the decline in risk of macular degeneration after quitting to data from 7 studies involving 1,488 patients. We assessed the cost-effectiveness of smoking cessation in terms of its impact on macular degeneration-related outcomes for 1,000 randomly selected U.S. smokers. We used a computer simulation model to predict the incidence of macular degeneration and blindness, the number of quality-adjusted life-years (QALYs), and direct costs (in 2004 U.S. dollars) until age 85 years. Cost-effectiveness ratios were based on the cost of the Massachusetts Tobacco Control Program. Costs and QALYs were discounted at 3% per year.

Results: If 1,000 smokers quit, our model predicted 48 fewer cases of macular degeneration, 12 fewer cases of blindness, and a gain of 1,600 QALYs. Macular degeneration-related costs would decrease by $2.5 million if the costs of caregivers for people with vision loss were included, or by $1.1 million if caregiver costs were excluded. At a cost of $1,400 per quitter, smoking cessation was cost-saving when caregiver costs were included, and cost about $200 per QALY gained when caregiver costs were excluded. Sensitivity analyses had a negligible impact. The cost per quitter would have to exceed $77,000 for the cost per QALY for smoking cessation to reach $50,000, a threshold above which interventions are sometimes viewed as not cost-effective.

Conclusion: Smoking cessation is unequivocally cost-effective in terms of its impact on age-related macular degeneration outcomes alone.

No MeSH data available.


Related in: MedlinePlus

Predicted declines over time after smoking cessation in the Relative Risk (RR) of neovascular age-related macular degeneration (AMD) and geographic atrophy, for ex-smokers compared with smokers.
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Figure 2: Predicted declines over time after smoking cessation in the Relative Risk (RR) of neovascular age-related macular degeneration (AMD) and geographic atrophy, for ex-smokers compared with smokers.

Mentions: The predicted declines in these risks over time are shown in Figure 2. The incidence probabilities for smokers were multiplied by these relative risks to obtain incidence probabilities for ex-smokers, and such probabilities 15 years after quitting are presented in Table 1.


Cost-effectiveness of smoking cessation to prevent age-related macular degeneration.

Hurley SF, Matthews JP, Guymer RH - Cost Eff Resour Alloc (2008)

Predicted declines over time after smoking cessation in the Relative Risk (RR) of neovascular age-related macular degeneration (AMD) and geographic atrophy, for ex-smokers compared with smokers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2562365&req=5

Figure 2: Predicted declines over time after smoking cessation in the Relative Risk (RR) of neovascular age-related macular degeneration (AMD) and geographic atrophy, for ex-smokers compared with smokers.
Mentions: The predicted declines in these risks over time are shown in Figure 2. The incidence probabilities for smokers were multiplied by these relative risks to obtain incidence probabilities for ex-smokers, and such probabilities 15 years after quitting are presented in Table 1.

Bottom Line: Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk.Cost-effectiveness ratios were based on the cost of the Massachusetts Tobacco Control Program.Macular degeneration-related costs would decrease by $2.5 million if the costs of caregivers for people with vision loss were included, or by $1.1 million if caregiver costs were excluded.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bainbridge Consultants, 222/299 Queen St, Melbourne, VIC 3000, Australia. susanhurley@bainbridgeconsultants.com

ABSTRACT

Background: Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk.

Methods: We fitted a function predicting the decline in risk of macular degeneration after quitting to data from 7 studies involving 1,488 patients. We assessed the cost-effectiveness of smoking cessation in terms of its impact on macular degeneration-related outcomes for 1,000 randomly selected U.S. smokers. We used a computer simulation model to predict the incidence of macular degeneration and blindness, the number of quality-adjusted life-years (QALYs), and direct costs (in 2004 U.S. dollars) until age 85 years. Cost-effectiveness ratios were based on the cost of the Massachusetts Tobacco Control Program. Costs and QALYs were discounted at 3% per year.

Results: If 1,000 smokers quit, our model predicted 48 fewer cases of macular degeneration, 12 fewer cases of blindness, and a gain of 1,600 QALYs. Macular degeneration-related costs would decrease by $2.5 million if the costs of caregivers for people with vision loss were included, or by $1.1 million if caregiver costs were excluded. At a cost of $1,400 per quitter, smoking cessation was cost-saving when caregiver costs were included, and cost about $200 per QALY gained when caregiver costs were excluded. Sensitivity analyses had a negligible impact. The cost per quitter would have to exceed $77,000 for the cost per QALY for smoking cessation to reach $50,000, a threshold above which interventions are sometimes viewed as not cost-effective.

Conclusion: Smoking cessation is unequivocally cost-effective in terms of its impact on age-related macular degeneration outcomes alone.

No MeSH data available.


Related in: MedlinePlus