Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study

Abstract

Background Internet and telephone treatments for smoking cessation can reach large numbers of smokers. There is little research on their costs and the impact of adherence on costs and effects. Objective To conduct an economic evaluation of The iQUITT Study, a randomised trial comparing Basic Internet, Enhanced Internet and Enhanced Internet plus telephone counselling (‘Phone’) at 3, 6, 12 and 18 months. Methods We used a payer perspective to evaluate the average and incremental cost per quitter of the three interventions using intention-to-treat analysis of 30-day single-point prevalence and multiple-point prevalence (MPP) abstinence rates. We also examined results based on adherence. Costs included commercial charges for each intervention. Discounting was not included given the short time horizon. Results Basic Internet had the lowest cost per quitter at all time points. In the analysis of incremental costs per additional quitter, Enhanced Internet+Phone was the most cost-effective using both single and MPP abstinence metrics. As adherence increased, the cost per quitter dropped across all arms. Costs per quitter were lowest among participants who used the ‘optimal’ level of each intervention, with an average cost per quitter at 3 months of US$7 for Basic Internet, US$164 for Enhanced Internet and US$346 for Enhanced Internet +Phone. Conclusions ‘Optimal’ adherence to internet and combined internet and telephone interventions yields the highest number of quitters at the lowest cost. Cost-effective means of ensuring adherence to such evidence-based programmes could maximise their population-level impact on smoking prevalence.

Patient experiences of nurse-led telephone follow-up following treatment for colorectal cancer

“…However, we did not attempt to carry out an economic evaluation of TFU for colorectal cancer. Other studies have demonstrated cost savings when using telephone contact with NHS patients instead of face to face consultations (Donohue et al, 2014, Gordon et al, 2014, Graham et al, 2013, Pinnock et al, 2005, Uppal et al, 2004. Further research is needed with a larger main trial to examine the economic costs of TFU for colorectal cancer to patients and the NHS in more detail.…”

Baseline Characteristics and Generalizability of Participants in an Internet Smoking Cessation Randomized Trial

“…Use is not restricted by geographical location and costs are often minimal or nonexistent to users through coverage by employers, health plans, or states, making it an ideal resource for those who do not have easy access to other cessation services. The costs of Internet programs are relatively fixed, resulting in greater efficiency as use increases (6, 13). Several large-scale randomized trials have shown quit rates of 18–20% at 12 months (14, 15) and meta-analyses and systematic reviews support the effectiveness of tailored and interactive interventions (5, 7, 8, 16).…”

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

“…We used a framework approach to interpretation of the data 111 as we felt that it best suited the practical and applied nature of the research to answer questions about health service development. Although this approach is based in the original accounts and observations of the participants, and therefore 'grounded' and inductive, it uses a priori categories to analyse the data.…”

“…Thus, reporting costs using the number of participants in a clinical trial will not provide an accurate reflection of the true cost per patient if the trial were rolled out to a wider patient group. 111 It is therefore recommended that the likely take-up rate for the intervention is taken into account to allow a more accurate estimate of the average costs per patient associated with ongoing costs for maintaining internet-based elements. 18 We therefore adjusted the ongoing costs associated with the web tool to give a more accurate estimate of these if the trial were rolled out.…”

“…Taking into account possible take-up rates, we allowed £2.00 per randomised partner to cover the costs of the web-based tool, following methods adopted in a previous study. 111 We allowed a cost for each randomised partner rather than each partner treated, as the web tool was provided irrespective of whether or not the partner chose to accept the allocated method of treatment. We varied these costs extensively within the sensitivity analysis.…”