Table 2. 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 the NY-ELCAP and NLST in authors' actuarial model.
NY-ELCAP stage shift | NLST stage shift | |
Screening | ||
Lung cancer screening and treatment costs | $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.