Cost-outcomes data, the unit costs of treatment when measured in terms of outcomes, are important to health plans deciding what therapies to cover. In a study comparing cost-effectiveness of various interventions, researchers at the Mayo Clinic have discovered that smoking cessation therapy is one of the best bargains in health care.

For comparison's sake, Mayo researchers couched their findings in terms of the cost of treatment per full year of life gained as a result of that care. Based on a model that considered the mean per-patient cost of smoking cessation services delivered through Mayo's Nicotine Dependence Clinic, patients' smoking cessation rates and years of life expected to be gained by those who quit, the resulting figure of $6,828 per year of life gained — expressed in such a way as to provide apples-to-apples cost-outcomes comparisons to other treatments — was relatively low (see chart below).

Put in those terms, smoking cessation is a more cost-effective intervention than breast cancer screenings and Pap smears, which are routinely covered by HMOs, and estrogen replacement therapy, which sometimes is not.

"This is strictly [a measure of the cost of] cessation treatment," says Kenneth Offord, associate professor of biostatistics and a lead researcher in the Mayo study. "If expenses such as patches or psychological counseling or the savings from not buying tobacco products were factored in, cost-effectiveness would be even greater."

Likewise, the study did not consider the estimated savings from treating smoking-related illnesses.

A cost-effective way of adding years to life

The cost of smoking cessation services, when expressed in terms of a formula that considers years of life gained from treatment, is a good deal compared with other preventive and life-saving interventions.

Source: MAYO CLINIC, ROCHESTER, MINN., 1997.

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Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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