***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND The objective of this study was to assess the cost-effectiveness of pravastatin therapy in survivors of myocardial infa rct ion with average cholesterol levels . METHODS We performed a cost-effectiveness analysis based on actual clinical , cost , and health-related quality -of-life data from the Cholesterol and Recurrent Events ( CARE ) trial . Survival and recurrent coronary heart disease events were modeled from trial data in Markov models , with the use of different assumptions regarding the long-term benefit of therapy . RESULTS Pravastatin therapy increased quality -adjusted life expectancy at an incremental cost of $ 16,000 to $ 32,000 per quality -adjusted life-year gained . In subgroup analyses , the cost-effectiveness of pravastatin therapy was more favorable for patients > 60 years of age and for patients with pretreatment low-density lipoprotein cholesterol levels > 125 mg/dL. Results were sensitive to the cost of pravastatin and to assumptions about long-term survival benefits from pravastatin therapy . CONCLUSIONS The cost-effectiveness of pravastatin therapy in survivors of myocardial infa rct ion with average cholesterol levels compares favorably with other interventions The Beaver Dam Health Outcomes Study ( BDHOS ) is an ongoing longitudinal cohort study of health status and health-related quality of life for a r and om sample of adults ( age range at interview was 45 to 89 years ; mean = 64.1 , SD = 10.8 ) in a community population . In a face-to-face interview lasting approximately an hour , each participant responds to several batteries of questions . Included are a history of chronic medical conditions , current medi cations , and past surgeries ; the SF-36 ( a general health-status question naire ) ; the Quality of Well-being index ; self-rated health status on a five-point scale from " excellent " to " poor " ; and evaluation of current health using the method of time tradeoffs . The authors present results from 1,356 interviews on these four principal measures , reporting mean scores by sex , by age , and for persons reporting being affected by various medical conditions . They believe data from the BDHOS will provide research ers and policy makers a reference col lection of vital statistics for health-related quality of life . Additionally , the data provide a way to compare results from studies that utilize different indices from among the four principal measures of the BDHOS . Key words : health status ; quality of life ( health-related ) ; population study ; cohort study . ( Med Decis Making 1993;13:89 - 102 PURPOSE To evaluate the incremental effectiveness and cost-effectiveness of a staged-based , computerized smoking cessation intervention relative to st and ard care in an urban managed care network of primary care physicians . DESIGN Decision-analytic model based on results of a r and omized clinical trial . METHODOLOGY Patient outcomes and cost estimates were derived from clinical trial data . Effectiveness was measured in terms of 7-day point-prevalence abstinence at 6 months post-intervention . Quality -adjusted life years ( QALYs ) and cost-effectiveness ( CE ) were calculated , with CE measured as cost per patient per life year saved and per quality -adjusted life years saved . CE estimates were adjusted to account for partial behavior change as measured in terms of progression in stage of readiness to quit . Sensitivity analyses were conducted to evaluate the robustness of key model assumptions . PRINCIPAL FINDINGS Intervention patients were 1.77 times more likely to be smoke-free at 6 months follow-up than those in st and ard care ( p=.078 ) . The intervention generated an additional 3.24 quitters per year . Annualized incremental costs were $ 5,570 per primary care practice , and $ 40.83 per smoker . The mean incremental cost-effectiveness ratio was $ 1,174 per life year saved ( $ 869 per QALY ) . When the intervention impact on progression in stage of readiness to quit was also considered , the mean incremental cost-effectiveness ratio declined to $ 999 per life year saved ( $ 739 per QALY ) . CONCLUSIONS From a physician 's practice perspective , the stage-based computer tailored intervention was cost-effective relative to st and ard care . Incorporation of partial behavior change into the model further enhanced favorability of the cost-effectiveness ratio BACKGROUND As many as 70 % of smokers with acute myocardial infa rct ion ( AMI ) continue to smoke after hospital discharge despite high rates of inpatient smoking cessation counseling . Supportive contact after discharge improves quit rates but is rarely used . METHODS Using data from a meta- analysis of r and omized trials of smoking cessation interventions and other published sources , we developed a Monte Carlo model to project health and economic outcomes for a hypothetical US cohort of 327,600 smokers hospitalized with AMI . We compared routine care , consisting of advice to quit smoking , with counseling with supportive follow-up , consisting of routine care and follow-up telephone calls from a nurse after discharge . Primary outcomes were number of smokers , AMIs , and deaths averted ; health care and productivity costs ; cost per quitter ; and cost per quality -adjusted life-year . RESULTS Implementation of smoking cessation counseling with follow-up contact for the 2010 cohort of hospitalized smokers would create 50,230 new quitters , cost $ 27.3 million in nurse wages and material s , and prevent 1380 nonfatal AMIs and 7860 deaths . During a 10-year period , it would save $ 22.1 million in reduced hospitalizations but increase health care costs by $ 166.4 million , primarily through increased longevity . Productivity costs from premature death would fall by $ 1.99 billion and nonmedical expenditures would increase by $ 928 million , for a net positive value to society of $ 894 million . The program would cost $ 540 per quitter considering only intervention costs . Cost-effectiveness would be $ 5050 per quality -adjusted life-year . Results were sensitive to the utility and incidence of nonfatal AMI and the potential effect of pharmacotherapies . CONCLUSION Smoking cessation counseling with supportive contact after discharge is potentially cost-effective and may reduce the incidence of smoking and its associated adverse health events and social costs Introduction : A r and omized trial has demonstrated that lung cancer screening reduces mortality . Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level . Methods : Six U.S. cohorts ( men and women aged 50 , 60 , or 70 years ) were simulated in an existing patient-level lung cancer model . Smoking histories reflected observed U.S. patterns . We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario . Costs per quality -adjusted life-year gained ( $ /QALY ) were estimated for each program : computed tomography screening ; st and -alone smoking cessation therapies ( 4–30 % 1-year abstinence ) ; and combined programs . Results : Annual screening of current and former smokers aged 50 to 74 years  costs between $ 126,000 and $ 169,000/QALY ( minimum 20 pack-years of smoking ) or $ 110,000 and $ 166,000/QALY ( 40 pack-year minimum ) , when compared with no screening and assuming background quit rates . Screening was beneficial but had a higher cost per QALY when the model included radiation-induced lung cancers . If screen participation doubled background quit rates , the cost of annual screening ( at age 50 years , 20 pack-year minimum ) was below $ 75,000/QALY . If screen participation halved background quit rates , benefits from screening were nearly erased . If screening had no effect on quit rates , annual screening  costs more but provided fewer QALYs than annual cessation therapies . Annual combined screening/cessation therapy programs at age 50 years costs $ 130,500 to $ 159,700/QALY , when compared with annual st and -alone cessation . Conclusions : The cost-effectiveness of computed tomography screening will likely be strongly linked to achievable smoking cessation rates . Trials and further modeling should explore the consequences of relationships between smoking behaviors and screen participation There is a lack of evidence of the relative cost-effectiveness of proactive telephone counseling ( PTC ) and Web-based delivery of smoking cessation services in conjunction with pharmacotherapy . We calculated the differential cost-effectiveness of three behavioral smoking cessation modalities with varenicline treatment in a r and omized trial of current smokers from a large health system . Eligible participants were r and omized to one of three smoking cessation interventions : Web-based counseling ( n = 401 ) , PTC ( n = 402 ) , or combined PTC-Web counseling ( n = 399 ) . All participants received a st and ard 12-week course of varenicline . The primary outcome was a 7-day point prevalent nonsmoking at the 6 month follow-up . The Web intervention was the least expensive followed by the PTC and PTC-Web groups . Costs per additional 6-month nonsmoker and per additional lifetime quitter were $ 1,278 and $ 2,601 for Web , $ 1,472 and $ 2,995 for PTC , and $ 1,617 and $ 3,291 for PTC-Web . Cost per life-year ( LY ) and quality -adjusted life-year ( QALY ) saved were $ 1,148 and $ 1,136 for Web , $ 1,320 and $ 1,308 for PTC , and $ 1,450 and $ 1,437 for PTC-Web . Based on the cost per LY and QALY saved , these interventions are among the most cost-effective life-saving medical treatments . Web , PTC , and combined PTC-Web treatments were all highly cost-effective , with the Web treatment being marginally more cost-effective than the PTC or combined PTC-Web treatments OBJECTIVES To determine the differential cost effectiveness of 2 dosing regimens of bupropion sustained release ( SR ) in combination with behavioral interventions of minimal intensity ( tailored mailings [ TM ] ) or moderate intensity ( proactive telephone calls [ PTC ] ) for smoking cessation in an actual practice setting . STUDY DESIGN Open-label , r and omized trial , with 1-year follow-up , conducted in a large health system based in Seattle , Washington . METHODS A total of 1524 adult smokers interested in quitting smoking were r and omly assigned to receive 150 mg bupropion SR daily and PTC ( n = 382 ) , 150 mg bupropion SR daily and TM ( n = 381 ) , 300 mg bupropion SR daily and PTC ( n = 383 ) , or 300 mg bupropion SR daily and TM ( n = 378 ) . Sufficient medication for 8 weeks of dosing was provided to patients . The primary outcome measure was self-reported point-prevalence 7-day nonsmoking status at 12 months after the target quit date . RESULTS Although the 300-mg dose was associated with a higher 12-month nonsmoking rate relative to the 150-mg dose with both PTC and TM , the additional cost result ed in lower cost effectiveness . The PTC behavioral intervention was more expensive than TM , but the additional effectiveness result ed in almost equivalent cost effectiveness at the 150-mg dose . Costs per additional 12-month nonsmoker ( above that expected for placebo ) for the 150-mg dose groups averaged 950 dollars and per additional lifetime quitter averaged 1508 dollars ; for the 300-mg groups these costs were 1342 dollars and 2129 dollars , respectively . Cost per life-year and quality -adjusted life-years ( QALYs ) saved varied substantially by age and treatment , but were no greater than 1100 dollars for all treatment groups when averaged across the age and sex distribution for the study population . CONCLUSIONS Although the cost per life-year and QALYs saved were sufficiently low for all doses to rate these smoking cessation interventions as among the most cost effective of life-saving medical treatments , within the regimens tested 150 mg bupropion combined with either PTC or TM was the most cost effective OBJECTIVES We assess the cost-effectiveness of  smoking relapse prevention interventions design ed to keep quitters from resuming the use of cigarettes . Because relapse prevention is complementary to smoking cessation efforts , the appropriate test of its cost-effectiveness is whether it reduces the incremental cost-effectiveness ratio ( ICER ) of smoking cessation . The major goal of the study is to carry out such a test . METHODS Data from a r and omized trial that ascertained the effectiveness of alternative modes of smoking relapse prevention are combined with ICER estimates of smoking cessation to assess whether relapse prevention is cost-effective . RESULTS The trial produced convincing evidence that relapse prevention yields statistically significant reductions in the proportion of quitters who are smoking at 24 months postquit . The intervention effects are substantial enough to raise the denominator terms of the smoking cessation ICER and , thereby , offset the amount relapse prevention adds to cost numerator terms . In this sense , smoking relapse prevention tends to pay for itself . CONCLUSIONS Smoking relapse prevention is a highly cost-effective addition to current efforts to curb cigarette consumption . Complementary 
    Output:
    
Conclusions Current estimates of the lifetime medical care costs and the QALYs associated with smoking are date d and do not reflect the latest evidence on the health effects of smoking , nor the current costs and benefits of smoking cessation and prevention .