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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
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.ORCID iD: 0000-0003-3329-6066
Karolinska Inst, Dept Publ Hlth Sci, Social Med, Stockholm, Sweden;Reykjavik Univ, Reykjavik, Iceland;Reykjavik Univ, Iceland Canc Soc, Reykjavik, Iceland.
Publ Hlth & Econ, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Malmo Univ, Fac Odontol, Malmo, Sweden.
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, article id e030934Article in journal (Refereed) Published
Abstract [en]

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 (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 Euro918 and Euro3786 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 Euro4000/QALY for tobacco cessation treatment.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2019. Vol. 9, article id e030934
Keywords [en]
smoking cessation, cost-effectivenes, long-term sustainability
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-402227DOI: 10.1136/bmjopen-2019-030934ISI: 000502537200371PubMedID: 31420398OAI: oai:DiVA.org:uu-402227DiVA, id: diva2:1386422
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-1399Available from: 2020-01-17 Created: 2020-01-17 Last updated: 2020-01-17Bibliographically approved

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