PROJECT

Cost effectiveness of Nicotine replacement therapy, Bupropion and Varenicline vs Placebo for smoking cessation in people who smoke tobacco

December 2025 - July 2026

Objectives:

1. To evaluate the cost-effectiveness of NRT, bupropion SR, and varenicline compared with placebo or usual care for smoking cessation among people who smoke tobacco in India. 2. To estimate incremental cost per quality-adjusted life year (QALY) gained from a health-system perspective. 3. To estimate the budget impact of scaling up pharmacological smoking cessation therapies within public sector health services in India over a five-year horizon.

Study Overview:

Tobacco smoking remains a major cause of preventable morbidity, mortality, and economic burden in India. This HTA aims to evaluate the cost-effectiveness of NRT, bupropion SR, and varenicline compared with placebo or usual care for smoking cessation among people who smoke tobacco in India. The analysis measures incremental cost per quality-adjusted life year (QALY) gained from a health-system perspective.

Study Approach:

The analysis will be conducted from a public payer perspective using a lifetime time horizon with health outcomes expressed in QALYs. A hybrid decision-analytic modelling framework comprising a short-term decision tree and a long-term Markov model will project lifetime costs and health outcomes according to smoking status. ICERs and incremental net monetary benefit (INMB) will be estimated and assessed against a willingness-to-pay threshold of one-time GDP per capita.

Expected Public Health Impact:

The study will generate an HTA report and policy brief to inform decisions on integrating pharmacological smoking cessation therapies into national tobacco control programmes. Clinical effectiveness parameters will be derived from systematic reviews and network meta-analyses, while cost inputs will be sourced from Indian costing databases and published literature. The study evaluates scaling up pharmacological smoking cessation therapies within public sector health services in India.