Raquel Cobos-Campos1, Javier Mar2,3,4, Antxon Apiñaniz5,6,7, Arantza Sáez de Lafuente5, Naiara Parraza5, Felipe Aizpuru7,8,9, Gorka Orive10,11,12,13,14. 1. Bioaraba Health Research Institute, Epidemiology and Public Health Research group, Vitoria-Gasteiz, Spain. raquel.coboscampos@osakidetza.eus. 2. Osakidetza Basque Health Service, Primary Care Research Unit of Gipuzkoa, Alto Deba Hospital, Arrasate-Mondragón, Spain. 3. Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain. 4. Biodonostia Health Research Institute, San Sebastián, Spain. 5. Bioaraba Health Research Institute, Epidemiology and Public Health Research group, Vitoria-Gasteiz, Spain. 6. Osakidetza Basque Health Service, Lakuabizkarra Health Centre, Vitoria-Gasteiz, Spain. 7. Preventive Medicine and Public Health Department, University of Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. 8. Osakidetza Basque Health Service, Subdirectorate of Health Care, Vitoria-Gasteiz, Spain. 9. Health Services Research on Chronic Patients Network (REDISSEC), Vitoria-Gasteiz, Spain. 10. NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. gorka.orive@ehu.eus. 11. Bioaraba Health Research Institute, Nanobiocel Research group, Vitoria-Gasteiz, Spain. gorka.orive@ehu.eus. 12. University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Spain. gorka.orive@ehu.eus. 13. Singapore Eye Research Institute, Singapore, Singapore. gorka.orive@ehu.eus. 14. CIBER Bioengineering, Biomaterials and Nanomedicine (CIBERBBN), Institute of Health Carlos III, Madrid, Spain. gorka.orive@ehu.eus.
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.
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.
Entities:
Keywords:
Cost of illness, MeSH unique ID: D017281; Costs and cost analysis, MeSH unique ID: D003365; Quality-adjusted life years, MeSH unique ID: D019057; Smoking cessation, MeSH unique ID: D016540; Text messaging, MeSH unique ID: D060145
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