D A Redelmeier1, M C Weinstein. 1. Department of Medicine, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Ontario, Canada. DAR@ICES.ON.CA
Abstract
PURPOSE: To evaluate the cost-effectiveness of regulations that prohibit using a cellular telephone while driving a motor vehicle. DESIGN: Decision analysis of risks and benefits related to cellular telephones and driving. SETTING: United States population in 1997. MEASURES: Health benefits measured as the quality-adjusted life years potentially saved. Financial benefits measured as health care and other services potentially averted. Costs of regulation measured as the lost productivity derived from willingness to pay for cellular telephone calls. RESULTS: Under base-case conditions, cellular telephone calls in the United States each day accounted for about 984 reported collisions, 1,729 total collisions, 2 deaths, 317 persons with injuries, 99 lost years of life expectancy, 161 lost quality-adjusted life years, $1 million in health care costs, and $4 million in property damage and other costs. This reflected a total of about 35 million telephone calls while driving, 70 million calling minutes, and $33 million in total value to society. The estimated cost-effectiveness ratio for a regulation restricting cellular telephone usage while driving was $300,000 per quality-adjusted life year saved, but ranged from $50,000 to $700,000 under alternative assumptions and interpretations of data. Regulations applied to teenage males could be cost-saving to society if the value of a call fell below 37 cents per minute. CONCLUSIONS: Regulations restricting cellular telephone usage while driving are less cost-effective for society than other safety measures. Nevertheless, regulations may be justifiable because the benefits and harms do not always involve the individual who has the cellular telephone. Increasing the price of a call (or adding a supplementary tax) might decrease the number of discretionary calls, be cost-saving for society, and be life-saving for individuals.
PURPOSE: To evaluate the cost-effectiveness of regulations that prohibit using a cellular telephone while driving a motor vehicle. DESIGN: Decision analysis of risks and benefits related to cellular telephones and driving. SETTING: United States population in 1997. MEASURES: Health benefits measured as the quality-adjusted life years potentially saved. Financial benefits measured as health care and other services potentially averted. Costs of regulation measured as the lost productivity derived from willingness to pay for cellular telephone calls. RESULTS: Under base-case conditions, cellular telephone calls in the United States each day accounted for about 984 reported collisions, 1,729 total collisions, 2 deaths, 317 persons with injuries, 99 lost years of life expectancy, 161 lost quality-adjusted life years, $1 million in health care costs, and $4 million in property damage and other costs. This reflected a total of about 35 million telephone calls while driving, 70 million calling minutes, and $33 million in total value to society. The estimated cost-effectiveness ratio for a regulation restricting cellular telephone usage while driving was $300,000 per quality-adjusted life year saved, but ranged from $50,000 to $700,000 under alternative assumptions and interpretations of data. Regulations applied to teenage males could be cost-saving to society if the value of a call fell below 37 cents per minute. CONCLUSIONS: Regulations restricting cellular telephone usage while driving are less cost-effective for society than other safety measures. Nevertheless, regulations may be justifiable because the benefits and harms do not always involve the individual who has the cellular telephone. Increasing the price of a call (or adding a supplementary tax) might decrease the number of discretionary calls, be cost-saving for society, and be life-saving for individuals.