Tobacco smoking is considered the most widespread avoidable health risk in Germany. Drugs for tobacco cessation are reimbursable under the statutory health insurance scheme for insured persons who are severely addicted to tobacco.
Against this background, the Federal Joint Committee had commissioned IQWiG to carry out a benefit assessment of four drugs that are intended to help combat severe tobacco addiction: bupropion, cytisine, nicotine and varenicline. Available studies showed proof of a benefit of nicotine and of varenicline compared to no drug therapy. There was a lack of data for bupropion, cytisine and various combinations of these drugs.
Together with Sabrina Kastaun from the Institute of General Practice (ifam) in Düsseldorf, the IQWiG authors have now explained the results of their meta-analysis in “Deutsches Ärzteblatt International”, focussing in particular on the question of whether the positive treatment effects of nicotine and of varenicline depend on the severity of tobacco addiction. This is not the case: The positive effects of varenicline and of nicotine in achieving permanent freedom from smoking are independent of the severity of tobacco addiction.