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Cost-effectiveness of a high-intensity versus a low-intensity smoking cessation intervention in a dental setting: long-term follow-up

16 Aug 2019

Objectives

The aim of this study was to conduct a cost-effectiveness analysis (CEA) of a high-intensity and a low-intensity smoking cessation treatment programme (HIT and LIT) using long-term follow-up effectiveness data and to validate the cost-effectiveness results based on short-term follow-up.

Design and outcome measures

Intervention effectiveness was estimated in a randomised controlled trial as numbers of abstinent participants after 1 and 5–8 years of follow-up. The economic evaluation was performed from a societal perspective using a Markov model by estimating future disease-related costs (in Euro () 2018) and health effects (in quality-adjusted life-years (QALYs)). Programmes were explicitly compared in an incremental analysis, and the results were presented as an incremental cost-effectiveness ratio.

Setting

The study was conducted in dental clinics in Sweden.

Participants

294 smokers aged 19–71 years were included in the study.

Interventions

Behaviour therapy, coaching and pharmacological advice (HIT) was compared with one counselling session introducing a conventional self-help programme (LIT).

Results

The more costly HIT led to higher number of 6-month continuous abstinent participants after 1 year and higher number of sustained abstinent participants after 5–8 years, which translates into larger societal costs avoided and health gains than LIT. The incremental cost/QALY of HIT compared with LIT amounted to 918 and 3786 using short-term and long-term effectiveness, respectively, which is considered very cost-effective in Sweden.

Conclusion

CEA favours the more costly HIT if decision makers are willing to spend at least 4000/QALY for tobacco cessation treatment.

Click here to view the full article which appeared in BMJ Open