Cost-effectiveness analysis of smoking cessation interventions using cell phones in a low-income population.
community outreach
cost and cost analysis
decision making
mobile clinic
smoking cessation
underserved populations
Journal
Tobacco control
ISSN: 1468-3318
Titre abrégé: Tob Control
Pays: England
ID NLM: 9209612
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
28
12
2017
revised:
27
03
2018
accepted:
19
04
2018
pubmed:
11
6
2018
medline:
8
8
2019
entrez:
11
6
2018
Statut:
ppublish
Résumé
The prevalence of cigarette smoking is significantly higher among those living at or below the federal poverty level. Cell phone-based interventions among such populations have the potential to reduce smoking rates and be cost-effective. We performed a cost-effectiveness analysis of three smoking cessation interventions: Standard Care (SC) (brief advice to quit, nicotine replacement therapy and self-help written materials), Enhanced Care (EC) (SC plus cell phone-delivered messaging) and Intensive Care (IC) (EC plus cell phone-delivered counselling). Quit rates were obtained from Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods). We evaluated shorter-term outcomes of cost per quit and long-term outcomes using cost per quality-adjusted life year (QALY). For men, EC cost an additional $541 per quit vs SC; however, IC cost an additional $5232 per quit vs EC. For women, EC was weakly dominated by IC-IC cost an additional $1092 per quit vs SC. Similarly, for men, EC had incremental cost-effectiveness ratio (ICER) of $426 per QALY gained vs SC; however, IC resulted in ICER of $4127 per QALY gained vs EC. For women, EC was weakly dominated; the ICER of IC vs SC was $1251 per QALY gained. The ICER was below maximum acceptable willingness-to-pay threshold of $50 000 per QALY under all alternative modelling assumptions. Cell phone interventions for low socioeconomic groups are a cost-effective use of healthcare resources. Intensive Care was the most cost-effective strategy both for men and women. NCT00948129; Results.
Sections du résumé
BACKGROUND
The prevalence of cigarette smoking is significantly higher among those living at or below the federal poverty level. Cell phone-based interventions among such populations have the potential to reduce smoking rates and be cost-effective.
METHODS
We performed a cost-effectiveness analysis of three smoking cessation interventions: Standard Care (SC) (brief advice to quit, nicotine replacement therapy and self-help written materials), Enhanced Care (EC) (SC plus cell phone-delivered messaging) and Intensive Care (IC) (EC plus cell phone-delivered counselling). Quit rates were obtained from Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods). We evaluated shorter-term outcomes of cost per quit and long-term outcomes using cost per quality-adjusted life year (QALY).
RESULTS
For men, EC cost an additional $541 per quit vs SC; however, IC cost an additional $5232 per quit vs EC. For women, EC was weakly dominated by IC-IC cost an additional $1092 per quit vs SC. Similarly, for men, EC had incremental cost-effectiveness ratio (ICER) of $426 per QALY gained vs SC; however, IC resulted in ICER of $4127 per QALY gained vs EC. For women, EC was weakly dominated; the ICER of IC vs SC was $1251 per QALY gained. The ICER was below maximum acceptable willingness-to-pay threshold of $50 000 per QALY under all alternative modelling assumptions.
DISCUSSION
Cell phone interventions for low socioeconomic groups are a cost-effective use of healthcare resources. Intensive Care was the most cost-effective strategy both for men and women.
TRIAL REGISTRATION NUMBER
NCT00948129; Results.
Identifiants
pubmed: 29886411
pii: tobaccocontrol-2017-054229
doi: 10.1136/tobaccocontrol-2017-054229
pmc: PMC6692895
mid: NIHMS1045159
doi:
Substances chimiques
Smoking Cessation Agents
0
Banques de données
ClinicalTrials.gov
['NCT00948129']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Pagination
88-94Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA225520
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA141628
Pays : United States
Informations de copyright
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Nicotine Tob Res. 2002 May;4(2):149-59
pubmed: 12028847
N Engl J Med. 2002 Oct 3;347(14):1087-93
pubmed: 12362011
Psychol Bull. 1992 Jan;111(1):23-41
pubmed: 1539088
Value Health. 2004 Jul-Aug;7(4):397-401
pubmed: 15449631
Nicotine Tob Res. 2007 Jun;9(6):631-46
pubmed: 17558820
Med Care. 2008 Apr;46(4):343-5
pubmed: 18362811
BMC Public Health. 2012 Aug 25;12:696
pubmed: 22920991
Eur J Health Econ. 2013 Oct;14(5):789-97
pubmed: 22961230
J Med Internet Res. 2013 Jan 28;15(1):e14
pubmed: 23353649
Popul Dev Rev. 2005 Jun;31(2):259-292
pubmed: 25035524
Addict Behav. 2015 Jun;45:79-86
pubmed: 25644592
J Subst Abuse Treat. 2015 Sep;56:1-10
pubmed: 25720333
BMC Med. 2015 Oct 12;13:257
pubmed: 26456865
Cochrane Database Syst Rev. 2015 Oct 12;(10):CD009670
pubmed: 26457723
Cochrane Database Syst Rev. 2016 Apr 10;4:CD006611
pubmed: 27060875
MMWR Morb Mortal Wkly Rep. 2016 Nov 11;65(44):1205-1211
pubmed: 27832052
Prim Care. 1995 Jun;22(2):261-70
pubmed: 7617785
Med Decis Making. 1994 Jul-Sep;14(3):259-65
pubmed: 7934713
JAMA. 1996 Apr 24;275(16):1247-51
pubmed: 8601956
JAMA. 1997 Dec 3;278(21):1759-66
pubmed: 9388153