Adding Smoking Cessation Estimated to Increase QALY and Lower Cost of Screening by 20 to 45%

Projected 15-year costs and quality-adjusted life years saved by lung cancer screening and treatment with and without smoking cessation using stage shifts from NY-ELCAP and NLST in authors' actuarial model.
  NY-ELCAP stage shift NLST stage shift
Screening
 
 
     Lung cancer
$27,824,282,242
$34,054,299,361
     QALYs saved by screening and treatment
985,284
722,795
     Cost per QALY saved
$28,240
$47,115
Screening + light smoking cessation intervention
 
 
     Additional costs for cessation
$1,361,556,665
$1,361,556,665
     Additional QALYs saved by cessation
273,566
273,566
     Cost per QALY saved
$23,185
$35,545
Screening + intensive smoking cessation intervention
 
 
A. NRT generic plus behavioral
 
 
     Additional costs for cessation
$3,212,191,737
$3,212,191,737
     Additional QALYs saved by cessation
930,754
930,754
     Cost per QALY saved
$16,198
$22,537
B. Bupropion generic plus behavioral
 
 
     Additional costs for cessation
$4,088,822,965
$4,088,822,965
     Additional QALYs saved by cessation
930,754
930,754
     Cost per QALY saved
$16,656
$23,067
C. Chantix plus behavioral
 
 
     Additional costs for cessation
$5,342,861,783
$5,342,861,783
     Additional QALYs saved by cessation
930,754
930,754
     Cost per QALY saved
$17,310
$23,826

NY-ELCAP, New York Early Lung Cancer Action Project; NLST, National Lung Screening Trial; QALY, quality-adjusted life year. doi:10.1371/journal.pone.0071379.t002

Villanti, Andrea & Jiang, Yiding & Abrams, David & Pyenson, Bruce. (2013). A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions. PloS one. 8. e71379. 10.1371/journal.pone.0071379.