Cost-effectiveness and productivity impacts of call-back telephone counselling for smoking cessation.

Few existing economic evaluations of telephone call-back services for smoking cessation (quitlines) include productivity measures. The Economics of Cancer Collaboration Tobacco Control (ECCTC) model was developed by adopting a societal perspective, including productivity impacts. Economic simulation modelling Methods: A multi-health state Markov cohort microsimulation model was constructed. The population was the Victorian smoking population in 2018. The effectiveness of the Victorian Quitline was informed by an evaluation and compared with no service. Risks of developing disease for smokers and former smokers were obtained from the literature. The model calculated economic measures, including average and total costs and health effects; incremental cost-effectiveness ratios; and net monetary benefit (NMB) for both the healthcare and societal perspective. An extensive uncertainty analysis was conducted. The Quitline service is cost-effective and dominant from both healthcare and societal perspectives, reducing costs with greater health benefits compared with no service. The expected incremental NMB was $2912 per person from the healthcare perspective and $7398 from the societal perspective. Total cost savings were $869 035 of healthcare costs, $1.1 million for absenteeism, $21.8 million for lost workforce participation, and $8.4 million for premature mortality, with a total reduction in societal costs of $32.2 million, over the 80 year timeframe of the model. Probabilistic sensitivity analysis suggested a high degree of certainty in these results, and overall conclusions were robust to one-way sensitivity and scenario analyses. The Victorian Quitline service is cost-effective and should be retained and expanded where possible. The ECCTC model can be adapted to analyse the cost-effectiveness of other tobacco cessation interventions, populations and contexts.

Déclaration de conflit d'intérêts

PC was funded by the Cancer Council Victoria and Quit Victoria. NM is the recipient of a Victorian Government Mid-Career Research Fellowship through the Victorian Cancer Agency (MCRF20049). She leads a research partnership between Cancer Council Victoria and Deakin Health Economics which funded the capacity to undertake this work. This research was funded by Quit Victoria, which runs the Quitline service evaluated in this analysis and is a program of Cancer Council Victoria, funded by Cancer Council Victoria, VicHealth, the Victorian Department of Health and the Australian Government Alcohol, Tobacco and Other Drugs Branch. MS reports funding grants from Quit Victoria from VicHealth and Cancer Council Victoria.