The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop
- Carla GuerrieroAffiliated withHealth Services Research and Policy, London School of Hygiene and Tropical Medicine Email author
- , John CairnsAffiliated withHealth Services Research and Policy, London School of Hygiene and Tropical Medicine
- , Ian RobertsAffiliated withPopulation Health, London School of Hygiene and Tropical Medicine
- , Anthony RodgersAffiliated withThe George Institute for Global Health, University of Sydney
- , Robyn WhittakerAffiliated withClinical Trials Research Unit, University of Auckland
- , Caroline FreeAffiliated withPopulation Health, London School of Hygiene and Tropical Medicine
The txt2stop trial has shown that mobile-phone-based smoking cessation support doubles biochemically validated quitting at 6 months. This study examines the cost-effectiveness of smoking cessation support delivered by mobile phone text messaging.
The lifetime incremental costs and benefits of adding text-based support to current practice are estimated from a UK NHS perspective using a Markov model. The cost-effectiveness was measured in terms of cost per quitter, cost per life year gained and cost per QALY gained. As in previous studies, smokers are assumed to face a higher risk of experiencing the following five diseases: lung cancer, stroke, myocardial infarction, chronic obstructive pulmonary disease, and coronary heart disease (i.e. the main fatal or disabling, but by no means the only, adverse effects of prolonged smoking). The treatment costs and health state values associated with these diseases were identified from the literature. The analysis was based on the age and gender distribution observed in the txt2stop trial. Effectiveness and cost parameters were varied in deterministic sensitivity analyses, and a probabilistic sensitivity analysis was also performed.
The cost of text-based support per 1,000 enrolled smokers is £16,120, which, given an estimated 58 additional quitters at 6 months, equates to £278 per quitter. However, when the future NHS costs saved (as a result of reduced smoking) are included, text-based support would be cost saving. It is estimated that 18 LYs are gained per 1,000 smokers (0.3 LYs per quitter) receiving text-based support, and 29 QALYs are gained (0.5 QALYs per quitter). The deterministic sensitivity analysis indicated that changes in individual model parameters did not alter the conclusion that this is a cost-effective intervention. Similarly, the probabilistic sensitivity analysis indicated a >90 % chance that the intervention will be cost saving.
This study shows that under a wide variety of conditions, personalised smoking cessation advice and support by mobile phone message is both beneficial for health and cost saving to a health system.
KeywordsSmoking cessation aid Economic evaluation Text message
- The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
The European Journal of Health Economics
Volume 14, Issue 5 , pp 789-797
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- Print ISSN
- Online ISSN
- Springer Berlin Heidelberg
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- Smoking cessation aid
- Economic evaluation
- Text message
- Industry Sectors
- Author Affiliations
- 1. Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- 4. Population Health, London School of Hygiene and Tropical Medicine, London, UK
- 2. The George Institute for Global Health, University of Sydney, Sydney, Australia
- 3. Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand