CONFERENCE PROCEEDING
Cost-effectiveness analysis of a disease-specific tobacco cessation intervention in the context of NCD clinics in India
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1
Health Sciences, University of York, York, United Kingdom
2
Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3
Commerce, Manipal Academy of Higher Education, Manipal, India
Publication date: 2025-06-23
Tob. Induc. Dis. 2025;23(Suppl 1):A775
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ABSTRACT
BACKGROUND: This study evaluates the cost-effectiveness of a tobacco cessation intervention tailored for patients attending non-communicable disease (NCD) clinics in India. Clinical effectiveness and cost data were sourced from a trial conducted at two district-level NCD clinics, involving patients who used tobacco in any form (smoked or smokeless). The intervention comprised four face-to-face, disease-specific cessation counseling sessions, disease-specific pamphlets, and short text messages in the vernacular language, compared to the usual care provided at these clinics.
METHODS: A decision tree model was used to simulate the cost implications and health outcomes over the patients' lifetime horizon. The primary outcome was the incremental cost per quality-adjusted life year (QALY) gained through the intervention. Analyses were conducted from an abridged societal perspective, applying a 3% annual discount rate as recommended by the Indian Health Technology Assessment Agency (HTAIn). Sensitivity analyses, including One-Way Sensitivity Analysis (OWSA) and Probabilistic Sensitivity Analysis (PSA), were undertaken to address uncertainties arising from potential variations in input parameters such as intervention costs, tobacco cessation rates, and health outcomes.
RESULTS: The lifetime incremental cost per person in the intervention scenario was estimated at ₹12.400, compared to the current scenario of usual care. The intervention resulted in a gain of 0.5 life years per person and 0.4 QALYs per person, with an Incremental Cost-Effectiveness Ratio (ICER) estimated to be ₹31.000 per QALY gained—significantly below the Indian cost-effectiveness threshold of ₹1.94,081 per QALY gained
CONCLUSIONS: This targeted tobacco cessation intervention is highly cost-effective in the Indian context, primarily driven by the prevention of expenditures on complications arising from prolonged tobacco use and the associated health losses. These findings advocate for the integration of tobacco control interventions into on-going public health services nationwide to optimize resource allocation and improve patient outcomes.