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dc.contributor.authorGordon, Louisaen_US
dc.contributor.authorHirst, Nicholasen_US
dc.contributor.authorYoung, Roberten_US
dc.contributor.authorBrown, Paulen_US
dc.date.accessioned2017-05-03T14:19:26Z
dc.date.available2017-05-03T14:19:26Z
dc.date.issued2010en_US
dc.date.modified2011-03-10T08:10:09Z
dc.identifier.issn14787547en_US
dc.identifier.doi10.1186/1478-7547-8-18en_AU
dc.identifier.urihttp://hdl.handle.net/10072/36149
dc.description.abstractBackground Many smoking-cessation programs and pharmaceutical aids demonstrate substantial health gains for a relatively low allocation of resources. Genetic information represents a type of individualized or personal feedback regarding the risk of developing lung cancer, and hence the potential benefits from stopping smoking, may motivate the person to remain smoke-free. The purpose of this study was to explore what the impact of a genetic test needs to have within a typical smoking-cessation program aimed at heavy smokers in order to be cost-effective. Methods Two strategies were modelled for a hypothetical cohort of heavy smokers aged 50 years; individuals either received or did not receive a genetic test within the course of a usual smoking-cessation intervention comprising nicotine replacement therapy (NRT) and counselling. A Markov model was constructed using evidence from published randomized controlled trials and meta-analyses for estimates on 12-month quit rates and long-term relapse rates. Epidemiological data were used for estimates on lung cancer risk stratified by time since quitting and smoking patterns. Extensive sensitivity analyses were used to explore parameter uncertainty. Results The discounted incremental cost per QALY was AU$34,687 (95% CI $12,483, $87,734) over 35 years. At a willingness-to-pay of AU$20,000 per QALY gained, the genetic testing strategy needs to produce a 12-month quit rate of at least 12.4% or a relapse rate 12% lower than NRT and counselling alone for it to be equally cost-effective. The likelihood that adding a genetic test to the usual smoking-cessation intervention is cost-effective was 20.6% however cost-effectiveness ratios were favourable in certain situations (e.g., applied to men only, a 60 year old cohort). Conclusions The findings were sensitive to small changes in critical variables such as the 12-month quit rates and relapse rates. As such, the cost-effectiveness of the genetic testing smoking cessation program is uncertain. Further clinical research on smoking-cessation quit and relapse rates following genetic testing is needed to inform its cost-effectiveness.en_US
dc.description.peerreviewedYesen_US
dc.description.publicationstatusYesen_AU
dc.format.extent433232 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglishen_US
dc.language.isoen_AU
dc.publisherBioMed Central Ltd.en_US
dc.publisher.placeUnited Kingdomen_US
dc.relation.ispartofstudentpublicationNen_AU
dc.relation.ispartofpagefrom1en_US
dc.relation.ispartofpageto10en_US
dc.relation.ispartofjournalCost Effectiveness and Resource Allocationen_US
dc.relation.ispartofvolume8en_US
dc.rights.retentionYen_AU
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classifieden_US
dc.subject.fieldofresearchcode119999en_US
dc.titleWithin a smoking-cessation program, what impact does genetic information on lung cancer need to have to demonstrate cost-effectiveness?en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
dcterms.licensehttp://creativecommons.org/licenses/by/2.0en_US
gro.description.notepublicPage numbers are not for citation purposes. Instead, this article has the unique article number of 2010 8:18.en_AU
gro.rights.copyrightCopyright 2010 Gordon et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_AU
gro.date.issued2010
gro.hasfulltextFull Text


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