Cost-effectiveness analysis of text messaging to support health advice for smoking cessation

Abstract

Background Smoking in one of the most serious public health problems. It is well known that it constitutes a major risk factor for chronic diseases and the leading cause of preventable death worldwide. Due to high prevalence of smokers, new cost-effective strategies seeking to increase smoking cessation rates are needed. Methods We performed a Markov model-based cost-effectiveness analysis comparing two treatments: health advice provided by general practitioners and nurses in primary care, and health advice reinforced by sending motivational text messages to smokers’ mobile phones. A Markov model was used in which smokers transitioned between three mutually exclusive health states (smoker, former smoker and dead) after 6-month cycles. We calculated the cost-effectiveness ratio associated with the sending of motivational messages. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costs for lost productivity, respectively. Additionally, deterministic sensitivity analysis was performed modifying the probability of smoking cessation with each option. Results Sending of text messages as a tool to support health advice was found to be cost-effective as it was associated with increases in costs of €7.4 and €1,327 per QALY gained (ICUR) for men and women respectively from a healthcare perspective, significantly far from the published cost-effectiveness threshold. From a societal perspective, the combined programmed was dominant. Conclusions Sending text messages is a cost-effective approach. These findings support the implantation of the combined program across primary care health centres.

A Method to Deliver Automated and Tailored Intervention Content: 24-month Clinical Trial

“…Text messaging is also cost effective, as indicated in our report and previous research [24], and unlike other digital interventions and strategies, it does not require a smartphone (with access to applications) or other devices, such as wearables, facilitating reach to sociodemographically diverse groups [1,25]. In fact, 97% of adults own a cellphone in the United States, with high rates across all race and ethnicity, household income, and educational attainment groups [1].…”

Development, validation and transfer to clinical practice of a mobile application for the treatment of smoking

“…All the information provided by the patient through the application is downloaded in real time to the electronic medical records. This program is also cost-effective, with an incremental cost-effectiveness ratio (ICER) of 7.4 euros for men and 1327 euros for women from a health perspective, 30 far from the 22,000 euros threshold calculated for the Spanish health system. 31 These results that agree with obtained by other research groups, 30 have been published previously.…”

Smoking Cessation Apps: A Systematic Review of Format, Outcomes, and Features

“…Second, they allow access to information in an easy and fast way. Finally, as some research has suggested that smoking cessation support by mobile phone messages is cost-saving [ 70 , 71 ], the use of smartphone apps could be a cost-effective approach to quit smoking.…”