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Varenicline

A Pharmacoeconomic Review of its Use as an Aid to Smoking Cessation

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Abstract

Varenicline (Chantix®, Champix®) is an orally administered a4b2 nicotinic acetylcholine receptor partial agonist that is indicated as an aid to smoking cessation.

Well designed clinical trials indicate that varenicline is an effective aid to smoking cessation. During the last 4 weeks of treatment, carbon monoxideconfirmed continuous abstinence rates were generally significantly higher with varenicline than with placebo, bupropion sustained release (SR) or nicotine replacement therapy. Varenicline also reduced cravings, the reinforcing effects of smoking and some withdrawal symptoms. Another well designed trial demonstrated that extending varenicline therapy by an additional 12 weeks helped maintain abstinence in individuals who had quit smoking.

Varenicline was generally well tolerated in clinical trials; nausea, the most commonly occurring adverse event, diminished over time. More data are needed regarding the potential for neuropsychiatric events in varenicline recipients. Some of these events may be associated with nicotine withdrawal, rather than varenicline, although neuropsychiatric events have been observed in individuals who continued to smoke whilst receiving varenicline.

In modelled cost-effectiveness analyses based on data from clinical trials in participants receiving smoking cessation therapy, 12 weeks’ treatment with varenicline was predicted to be cost effective from a healthcare payer perspective in numerous countries. With regard to the incremental costs per QALY or life-year gained, 12 weeks treatment with varenicline consistently dominated bupropion SR and nicotine replacement therapy and was dominant over or considered cost effective relative to unaided cessation, regular brief counselling or nortriptyline in analyses based on Markov models.

In additional modelled analyses from a healthcare payer perspective, administering varenicline for an additional 12 weeks in participants who had successfully quit smoking was estimated to have acceptable incremental costs per QALY gained relative to varenicline for 12 weeks and to dominate other smoking cessation options.

Moreover, in Swedish analyses that also included societal costs for production and consumption, the incremental cost per QALY gained for varenicline versus bupropion SR, and for an additional 12 weeks of varenicline therapy versus varenicline for 12 weeks only, was below commonly accepted thresholds of cost effectiveness.

A US decision-analytic model from the perspective of various US health insurance plans demonstrated that, after 2 years, varenicline was predicted to dominate bupropion SR, in terms of the incremental cost per additional smoking cessation. Varenicline was also dominant or cost effective versus nicotine replacement therapy, and cost effective versus unaided cessation.

Sensitivity analyses demonstrated that the results of cost-effectiveness studies were generally robust to plausible variations in key parameters.

In conclusion, varenicline is an effective aid to smoking cessation. Varenicline was generally well tolerated in clinical trials, although more data are needed regarding the potential for neuropsychiatric events. The costs associated with varenicline are offset by direct savings associated with the reduction in smokingrelated diseases. Despite their limitations, available pharmacoeconomic analyses from numerous countries support the use of varenicline for 12 or 24 weeks as a cost-effective treatment relative to other smoking cessation therapies in smokers who wish to quit smoking.

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References

  1. Stack NM. Smoking cessation: an overview of treatment options with a focus on varenicline. Pharmacotherapy 2007 Nov; 27 (11): 1550–7

    Article  PubMed  CAS  Google Scholar 

  2. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. preventive services task force reaffirmation recommendation statement. Ann Intern Med 2009 Apr 21; 150 (8): 551–5

  3. Edwards R. ABC of smoking cessation: the problem of tobacco smoking. BMJ 2004 Jan 24; 328 (7433): 217–9

    Article  PubMed  Google Scholar 

  4. Ezzati M, Lopez AD. Regional, disease specific patterns of smoking-attributable mortality in 2000. Tob Control 2004 Dec; 13 (4): 388–95

    Article  PubMed  CAS  Google Scholar 

  5. Menzin J, Lines LM, Marton J. Estimating the short-term clinical and economic benefits of smoking cessation: do we have it right? Expert Rev Pharmacoecon Outcomes Res 2009 Jun; 9 (3): 257–64

    Article  PubMed  Google Scholar 

  6. Hays JT, Ebbert JO, Sood A. Efficacy and safety of varenicline for smoking cessation. Am J Med 2008 Apr; 121 (4 Suppl. 1): S32–42

    Article  Google Scholar 

  7. Kenfield SA, Stampfer MJ, Rosner BA, et al. Smoking and smoking cessation in relation to mortality in women. JAMA 2008 May 7; 299 (17): 2037–47

    Article  PubMed  CAS  Google Scholar 

  8. Fiore MC, Jaén CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update [online]. Available from URL: http://www.surgeongeneral.gov/tobacco/treating_tobacco_use08.pdf [Accessed 2009 Sep 15]

  9. Galanti LM. Tobacco smoking cessation management: integrating varenicline in current practice. Vasc Health Risk Manag 2008; 4 (4): 837–45

    PubMed  CAS  Google Scholar 

  10. Mohiuddin SM, Mooss AN, Hunter CB, et al. Intensive smoking cessation intervention reduces mortality in highrisk smokers with cardiovascular disease. Chest 2007 Feb; 131 (2): 446–52

    Article  PubMed  Google Scholar 

  11. Keating GM, Siddiqui MAA. Varenicline: a review of its use as an aid to smoking cessation therapy. CNS Drugs 2006; 20 (11): 945–60

    Article  PubMed  CAS  Google Scholar 

  12. Keiding H. Cost-effectivenss of varenicline for smoking cessation. Expert Rev Pharmacoecon Outcomes Res 2009; 9 (3): 215–21

    Article  PubMed  Google Scholar 

  13. Guindon GE, Boisclair D. Past, current and future trends in tobacco use [online]. Available from URL: http://www1.worldbank.org/tobacco/pdf/Guindon-Past,%20current-%20whole.pdf [Accessed 2009 Sep 24]

  14. Smoking-attributable mortality, years of potential life lost, and productivity losses: United States, 2000-2004. MMWR Morb Mortal Wkly Rep 2008 Nov 14; 57 (45): 1226–8

  15. Armour BS, Finkelstein EA, Fiebelkorn IC. State-level Medicaid expenditures attributable to smoking. Prev Chronic Dis 2009 Jul; 6 (3): 1–10

    Google Scholar 

  16. Allender S, Balakrishnan R, Scarborough P, et al. The burden of smoking-related ill health in the UK. Tob Control 2009 Aug; 18 (4): 262–7

    Article  PubMed  CAS  Google Scholar 

  17. World Health Organization. The European tobacco control report 2007 [online]. Available from URL: http://www.euro.who.int/document/e89842.pdf [Accessed 2009 Sep 24]

  18. Gonzales D, Rennard SI, Nides M, et al. Varenicline, an a4b2 nicotinic acetylcholine receptor partial agonist, vs sustainedrelease bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA 2006 Jul 5; 296 (1): 47–55

    Article  PubMed  CAS  Google Scholar 

  19. Jorenby DE, Hays JT, Rigotti NA, et al. Efficacy of varenicline, an a4b2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006 Jul 5; 296 (1): 56–63

    Article  PubMed  CAS  Google Scholar 

  20. Nakamura M, Oshima A, Fujimoto Y, et al. Efficacy and tolerability of varenicline, an a4b2 nicotinic acetylcholine receptor partial agonist, in a 12-week, randomized, placebo-controlled, dose-response study with 40-week follow-up for smoking cessation in Japanese smokers. Clin Ther 2007 Jun; 29 (6): 1040–56

    Article  PubMed  CAS  Google Scholar 

  21. Aubin H-J, Bobak A, Britton JR, et al. Varenicline versus transdermal nicotine patch for smoking cessation: results from a randomised open-label trial. Thorax 2008 Aug; 63 (8): 717–24

    Article  PubMed  Google Scholar 

  22. Tonstad S, Tønnesen P, Hajek P, et al. Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA 2006 Jul 5; 296 (1): 64–71

    Article  PubMed  CAS  Google Scholar 

  23. Wang C, Xiao D, Chan KPW, et al. Varenicline for smoking cessation: a placebo-controlled, randomized study. Respirology 2009 Apr; 14 (3): 384–92

    Article  PubMed  Google Scholar 

  24. Tsai S-T, Cho H-J, Cheng H-S, et al. A randomized, placebocontrolled trial of varenicline, a selective a4b2 nicotinic acetylcholine receptor partial agonist, as a new therapy for smoking cessation in Asian smokers. Clin Ther 2007 Jun; 29 (6): 1027–39

    Article  PubMed  CAS  Google Scholar 

  25. Niaura R, Hays JT, Jorenby DE, et al. The efficacy and safety of varenicline for smoking cessation using a flexible dosing strategy in adult smokers: a randomized controlled trial. Curr Med Res Opin 2008 Jul; 24 (7): 1931–41

    Article  PubMed  CAS  Google Scholar 

  26. Oncken C, Gonzales D, Nides M, et al. Efficacy and safety of the novel selective nicotinic acetylcholine receptor partial agonist, varenicline, for smoking cessation. Arch Intern Med 2006 Aug 14/28; 166 (15): 1571–7

    Article  PubMed  CAS  Google Scholar 

  27. Nides M, Oncken C, Gonzales D, et al. Smoking cessation with varenicline, a selective a4b2 nicotinic receptor partial agonist: results from a 7-week, randomized, placebo- and bupropion-controlled trial with 1-year follow-up. Arch Intern Med 2006 Aug 14/28; 166 (15): 1561–8

    Article  PubMed  Google Scholar 

  28. Nides M, Glover ED, Reus VI, et al. Varenicline versus bupropion SR or placebo for smoking cessation: a pooled analysis. Am J Health Behav 2008 Nov-Dec; 32 (6): 664–75

    Article  PubMed  Google Scholar 

  29. Pfizer Inc. Chantix® (varenicline) tablets: US prescribing information [online]. Available from URL: http://media.pfizer.com/files/products/uspi_chantix.pdf [Accessed 2009 Sep 15]

  30. European Medicines Agency. Champix (varenicline filmcoated tablets): summary of product characteristics [online]. Available from URL: http://www.emea.europa.eu/humandocs/PDFs/EPAR/champix/H-699-PI-en.pdf [Accessed 2009 Sep 22]

  31. Russ C, Davies S, Flammer M, et al. Incidence of psychiatric adverse events other than depression in placebo-controlled clincial trials involving varenicline [abstract]. 10th Annual Conference of the Society for Research on Nicotine and Tobacco Europe; 2008 Sep 23-26; Rome

    Google Scholar 

  32. Tonstad S, Davies S, Flammer M, et al. Incidence of depression in placebo-controlled clinical trials involving varenicline [abstract]. 10th Annual Conference of the Society for Research on Nicotine and Tobacco Europe; 2008 Sep 23–26; Rome

    Google Scholar 

  33. Gunnell D, Irvine D, Wise L, et al. Varenicline and suicidal behaviour: a cohort study based on data from the General Practice Research Database. BMJ 2009 Oct 1; 339: b3805

    Article  Google Scholar 

  34. Glaxo Smith Kline. Zyban® (bupropion hydrochloride) sustained-release tablets: US prescribing information [online]. Available from URL: http://us.gsk.com/products/assets/us_zyban.pdf [Accessed 2009 Sep 15]

  35. Annemans L, Nackaerts K, Bartsch P, et al. Cost effectiveness of varenicline in Belgium, compared with bupropion, nicotine replacement therapy, brief counselling and unaided smoking cessation: a BENESCO Markov costeffectiveness analysis. Clin Drug Invest 2009; 29 (10): 655–65

    Article  CAS  Google Scholar 

  36. Bolin K, Mörk A-C, Willers S, et al. Varenicline as compared to bupropion in smoking-cessation therapy: cost-utility results for Sweden 2003. Respir Med 2008 May; 102 (5): 699–710

    Article  PubMed  Google Scholar 

  37. Fernändez de Bobadilla Osorio J, Sánchez-Maestre C, Brosa Riestra M. Cost effectiveness analysis of varenicline (Champix®) for the treatment of smoking in Spain [in Spanish]. An Med Interna 2008; 25 (7): 342–8

    Google Scholar 

  38. Hoogendoorn M, Welsing P, Rutten-van Mölken MPMH. Cost-effectiveness of varenicline compared with bupropion, NRT, and nortriptyline for smoking cessation in the Netherlands. Curr Med Res Opin 2008 Jan; 24 (1): 51–61

    PubMed  Google Scholar 

  39. Howard P, Knight C, Boler A, et al. Cost-utility analysis of varenicline versus existing smoking cessation strategies using the BENESCO simulation model: application to a population of US adult smokers. Pharmacoeconomics 2008; 26 (6): 497–511

    Article  PubMed  CAS  Google Scholar 

  40. Lee KK, Lee VWY, Chow DP. Cost effectiveness of varenicline compared with existing smoking cessation strategies in Hong Kong [abstract no. PRS16]. 12th Annual European Congress of the International Society for Pharmacoeconomics and Outcomes Research; 2009 Oct 24-29; Paris

    Google Scholar 

  41. Linden K, Jormanainen V, Linna M, et al. Cost effectiveness of varenicline versus bupropion and unaided cessation for smoking cessation in a cohort of Finnish adult smokers. Curr Med Res Opin. Epub 2010 Jan 6

    Google Scholar 

  42. Mould-Quevedo JF, Contreras-Hernández I. Análisis costeefectividad de vareniclina (Champix®) frente a los parches de nicotina en el tratamiento del tabaquismo en México. Pharmacoeconomics Span Res Articles 2009; 6 (1): 22–32

    Google Scholar 

  43. Narváez J, Alvis N, de La Hoz F, et al. An economic evaluation of a pharmacological intervention using varenicline as therapy for smoking cessation [abstract no. PRS16]. Value Health 2009 May; 12 (3): A123

    Article  Google Scholar 

  44. O’Regan CP, Baker CL, Marchant N. The cost-effectiveness of the novel prescription therapy varenicline in Scotland [abstract no. RPOS3-45 plus poster]. 13th Annual Meeting of the Society for the Research on Nicotine and Tobacco; 2007 Feb 21-24; Austin (TX)

    Google Scholar 

  45. Poulsen PB, Dollerup J, Keiding H. The cost-effectiveness of varenicline in smoking cessation in Denmark [abstract plus poster]. International Society for Pharmacoeconomics and Outcomes Research 11th Annual European Congress; 2008 Nov 8-11; Athens

    Google Scholar 

  46. Rasch A, Greiner W. Gesundheitsökonomisches Modell der Raucherentwöhnung mit Vareniclin. Suchtmed Forsch Prax 2009 Sep; 11 (2): 47–55

    Google Scholar 

  47. Skoupá J, Doležal T, Hájek P, et al. Long-term cost-effectiveness analysis of varenicline versus nicotine replacement therapy, bupropion, and unaided cessation for smoking cessation in the Czech Republic [abstract plus poster]. 10th Annual Meeting of the Society for Research on Nicotine and Tobacco Europe; 2008 Sep 23-26; Rome

    Google Scholar 

  48. Bolin K, Wilson K, Benhaddi H. Cost-effectiveness of varenicline compared with nicotine patches for smoking cessation: results from four European countries. Eur J Public Health 2009 Dec; 19 (6): 650–4

    Article  PubMed  Google Scholar 

  49. Linden K, Kotomäki T, Wilson K. Cost-effectiveness of varenicline versus nicotine replacement therapy for smoking cessation in Finland [abstract plus poster]. 10th Annual Meeting of the Society for Research on Nicotine and Tobacco Europe; 2008 Sep 23-26; Rome

    Google Scholar 

  50. Bolin K, Mörk A-C, Wilson K. Smoking-cessation therapy using varenicline: the cost-utility of an additional 12-week course of varenicline for the maintenance of smoking abstinence. J Eval Clin Pract 2009 Jun; 15 (3): 478–85

    Article  PubMed  Google Scholar 

  51. Knight C, Howard P, Baker CL, et al. The cost-effectiveness of an extended course (12 + 12 weeks) of varenicline compared with other available smoking cessation strategies in the United States: an extension and update to the BENESCO model. Value Health. Epub 2009 Nov 13

    Google Scholar 

  52. Igarashi A, Takuma H, Fukuda T, et al. Cost-utility analysis of varenicline, an oral smoking-cessation drug, in Japan. Pharmacoeconomics 2009; 27 (3): 247–61

    Article  PubMed  Google Scholar 

  53. Bae JY, Song HJ, Joe KH, et al. A long term costeffectiveness analysis model for smoking cessation in Korea [abstract no. PRS20 plus poster]. 13th Annual International Meeting of the International Society for Pharmacoeconomics and Outcomes Research; 2008 May 3-7; Toronto (ON)

    Google Scholar 

  54. Halpern MT, Dirani R, Schmier JK. The cost effectiveness of varenicline for smoking cessation. Manag Care Interface 2007 Oct; 20 (10): 18–25

    PubMed  Google Scholar 

  55. Orme ME, Hogue SL, Kennedy LM, et al. Development of the health and economic consequences of smoking interactive model. Tob Control 2001 Mar; 10 (1): 55–61

    Article  PubMed  CAS  Google Scholar 

  56. Thun MJ, Apicella LF, Henley SJ. Smoking vs other risk factors as the cause of smoking-attributable deaths: confounding in the courtroom. JAMA 2000 Aug 9; 284 (6): 706–12

    Article  PubMed  CAS  Google Scholar 

  57. Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2006; (4): CD000031

  58. Silagy C, Lancaster T, Stead L, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2004; (3): CD000146

  59. Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008; (1): CD000146

  60. Foulds J, Burke M, Steinberg M, et al. Advances in pharmacotherapy for tobacco dependence. Expert Opin Emerg Drugs 2004 May; 9 (1): 39–53

    Article  PubMed  CAS  Google Scholar 

  61. Kjaer NT, Evald T, Rasmussen M, et al. The effectiveness of nationally implemented smoking interventions in Denmark. Prev Med 2007 Jul; 45 (1): 12–4

    Article  PubMed  CAS  Google Scholar 

  62. Wetter DW, Cofta-Gunn L, Fouladi RT. Late relapse/sustained abstinence among former smokers: a longitudinal study. Prev Med 2004 Dec; 39 (6): 1156–63

    Article  PubMed  Google Scholar 

  63. Krall EA, Garvey AJ, Garcia RI. Smoking relapse after 2 years of abstinence: findings from the VA Normative Aging Study. Nicotine Tob Res 2002 Feb; 4 (1): 95–100

    Article  PubMed  Google Scholar 

  64. Feenstra TL, van Baal PHM, Hoogenveen RT, et al. Costeffectiveness of interventions to reduce tobacco smoking in the Netherlands: an application of the RIVM chronic disease model [online]. Available from URL: http://www.rivm.nl/bibliotheek/rapporten/260601003.pdf [Accessed 2009 Jan 5]

  65. Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999 Mar 4; 430 (9): 685–91

    Article  Google Scholar 

  66. Cromwell J, Bartosch WJ, Fiore MC, et al. Cost-effectiveness of the clinical practice recommendations in the AHCPR guideline for smoking cessation. JAMA 1997 Dec 3; 278 (21): 1759–66

    Article  PubMed  CAS  Google Scholar 

  67. US Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress. A report of the surgeon general. Atlanta (GA): US Department of Health and Human Services, CDC, 1989

    Google Scholar 

  68. Jackson KC 2nd, Nahoopii R, Said Q, et al. An employerbased cost-benefit analysis of a novel pharmacotherapy agent for smoking cessation. J Occup Environ Med 2007 Apr; 49 (4): 453–60

    Article  PubMed  Google Scholar 

  69. Taylor DCA, Chu P, Rosen VM, et al. Budgetary impact of varenicline in smoking cessation in the United Kingdom. Value Health 2009; 12 (1): 28–33

    Article  PubMed  Google Scholar 

  70. Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004 Jan; 99 (1): 29–38

    Article  PubMed  Google Scholar 

  71. Woolacott NF, Jones L, Forbes CA, et al. The clinical effectiveness and cost-effectiveness of bupropion and nicotine replacement therapy for smoking cessation: a systematic review and economic evaluation. Health Technol Assess 2002; 6 (16): 1–245

    CAS  Google Scholar 

  72. Richmond RL, Kehoe L, de Almedia Neto AC. Three year continuous abstinence in a smoking cessation study using the nicotine transdermal patch. Heart 1997 Dec; 78 (6): 617–8

    PubMed  CAS  Google Scholar 

  73. Vemer P, Rutten-van Mölken MPMH. Crossing borders: factors affecting differences in cost-effectiveness of smoking cessation interventions between European countries. Value Health. Epub 2009 Sep 25

    Google Scholar 

  74. National Institute for Health and Clinical Excellence. Varenicline for smoking cessation [online]. Available from URL: http://www.nice.org.uk/nicemedia/pdf/TA123Guidance.pdf [Accessed 2009 Sep 23]

  75. Spirling LI, Stapleton JA, Sutherland G. Suicidal ideation and varenicline: a possible case of mistaken adverse drug reaction? [letter]. J Clin Psychiatry 2008 Nov; 69 (11): 1834–5

    Article  PubMed  Google Scholar 

  76. Popkin MK. Exacerbation of recurrent depression as a result of treatment with varenicline [letter]. Am J Psychiatry 2008 Jun; 165 (6): 774

    Article  PubMed  Google Scholar 

  77. Pirmoradi P, Roshan S, Nadeem SS. Neuropsychiatric disturbance after initiation of varenicline in a patient with a history of alcohol abuse and major depression. Am J Health Syst Pharm 2008 Sep 1; 65 (17): 1624–6

    Article  PubMed  CAS  Google Scholar 

  78. Lyon GJ. Possible varenicline-induced paranoia and irritability in a patient with major depressive disorder, borderline personality disorder, and methamphetamine abuse in remission [letter]. J Clin Psychopharmacol 2008 Dec; 28 (6): 720–1

    Article  PubMed  Google Scholar 

  79. Laine P, Marttila J, Lindeman S. Hallucinations in the context of varenicline withdrawal [letter]. Am J Psychiatry 2009 May; 166 (5): 619–20

    Article  PubMed  Google Scholar 

  80. Lasser KE, Boyd JW. Varenicline and smokers with mental illnesses [letter]. Lancet 2008 Oct 4; 372 (9645): 1218–9

    Article  PubMed  Google Scholar 

  81. Kohen I, Kremen N. Varenicline-induced manic episode in a patient with bipolar disorder [letter]. Am J Psychiatry 2007 Aug; 164 (8): 1269–70

    Article  PubMed  Google Scholar 

  82. Freedman R. Exacerbation of schizophrenia by varenicline [letter]. Am J Psychiatry 2007 Aug; 164 (8): 1269

    Article  PubMed  Google Scholar 

  83. Di Paula BA, Thomas MD. Worsening psychosis induced by varenicline in a hospitalized psychiatric patient. Pharmacotherapy 2009 Jul; 29 (7): 852–7

    Article  Google Scholar 

  84. Cahill K, Stead L, Lancaster T. A preliminary benefit-risk assessment of varenicline in smoking cessation. Drug Saf 2009; 32 (2): 119–35

    Article  PubMed  CAS  Google Scholar 

  85. Hays JT. The risk-benefit balance of varenicline for smoking cessation. J Thorac Oncol 2008 Sep; 3 (9): 949–50

    Article  PubMed  Google Scholar 

  86. Purvis TL, Mambourg SE, Balvanz TM, et al. Safety and effectiveness of varenicline in a veteran population with a high prevalence of mental illness. Ann Pharmacother 2009 May; 43 (5): 862–7

    Article  PubMed  CAS  Google Scholar 

  87. Stapleton JA, Watson L, Spirling LI, et al. Varenicline in the routine treatment of tobacco dependence: a pre-post comparison with nicotine replacement therapy and an evaluation in those with mental illness. Addiction 2008 Jan; 103 (1): 146–54

    Article  PubMed  Google Scholar 

  88. Smith RC. Cognitive antismoking and psychiatric effects of varenicline in patients with schizophrenia or schizoaffective disorder [abstract no. P-35-015]. 9th World Congress of Biological Psychiatry; 2009 Jun 28-Jul 2; Paris

    Google Scholar 

  89. Kuehn BM. Varenicline gets stronger warnings about psychiatric problems, vehicle crashes. JAMA 2009 Aug 26; 302 (8): 834

    Article  PubMed  CAS  Google Scholar 

  90. Kasliwal R, Wilton LV, Shakir SAW. Safety and drug utilization profile of varenicline as used in general practice in England: interim results from a prescription-event monitoring study. Drug Saf 2009; 32 (6): 499–507

    Article  PubMed  CAS  Google Scholar 

  91. Kaper J, Wagena EJ, Willemsen MC, et al. A randomized controlled trial to assess the effects of reimbursing the costs of smoking cessation therapy on sustained abstinence. Addiction 2006 Nov; 101 (11): 1656–61

    Article  PubMed  CAS  Google Scholar 

  92. Reda AA, Kaper J, Fikretler H, et al. Healthcare financing systems for increasing the use of tobacco dependence treatment. Cochrane Database Syst Rev 2008; 4: CD004305

    Google Scholar 

  93. Kaper J, Wagena EJ, van Schayck CP, et al. Encouraging smokers to quit: the cost effectiveness of reimbursing the costs of smoking cessation treatment. Pharmacoeconomics 2006; 24 (5): 453–64

    Article  PubMed  Google Scholar 

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    Gillian M. Keating & Katherine A. Lyseng-Williamson

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Keating, G.M., Lyseng-Williamson, K.A. Varenicline. Pharmacoeconomics 28, 231–254 (2010). https://doi.org/10.2165/11204380-000000000-00000

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