Investigating the cost-effectiveness of three cessation interventions on a national scale using the Economics of Smoking in Pregnancy (ESIP) decision analytical model

Matthew Jones*, Murray Smith, Sarah Lewis, Steve Parrott, Tim Coleman

*Awdur cyfatebol y gwaith hwn

Allbwn ymchwil: Cyfraniad at gyfnodolynErthygladolygiad gan gymheiriaid

62 Wedi eu Llwytho i Lawr (Pure)

Crynodeb

Aim
To measure the cost-effectiveness of adding text message (TMB), exercise (EB) and abstinent-contingent financial incentive-based (CFIB) stop smoking interventions to standard smoking cessation support for pregnant women in England.

Design
Modelling cost-effectiveness outcomes by separately adding three cessation interventions to standard cessation care offered to pregnant women in England. English National Health Service Stop Smoking Services (NHS SSS) statistics from 2019 to 2020 were used for estimating the base quit rate. Intervention effectiveness and cost data for interventions were taken from trial reports. Cost-effectiveness was derived using the economics of smoking in pregnancy (ESIP) model from a health service and personal social services perspective. Interventions were compared with each other as well as against standard cessation care.

Setting
English NHS SSS.

Participants/cases
A total of 13 799 pregnant women who accessed NHS SSS. Interventions and comparator; comparator: standard stop smoking support comprising behavioural intervention and an offer of nicotine replacement therapy (NRT). Three additive interventions were TMB, EB and CFIB.

Measurements
Incremental cost-effectiveness ratios per quality-adjusted life-years gained for both mothers and offspring over their life-times; return on investment (ROI); and cost-effectiveness acceptability curves (CEACs).

Findings
The addition of any of the interventions compared with standard care alone was preferred, but only significant for the addition of CFIB, with the CEAC suggesting an at least 90% chance of being favoured to standard care alone. When compared against each other CFIB appeared to yield the largest returns, but this was not significant. The estimated ROI for CFIB was £2 [95% confidence interval (CI) = £1–3] in health-care savings for every £1 spent by the NHS on the cessation intervention.

Conclusions
For a health system which currently provides behavioural support and an offer of nicotine replacement therapy as standard stop smoking support for pregnant women, the greatest economic gains would be provided by operating an abstinent-contingent financial incentives scheme alongside this.
Iaith wreiddiolSaesneg
Tudalennau (o-i)2907-2917
Nifer y tudalennau11
CyfnodolynAddiction
Cyfrol117
Rhif cyhoeddi11
Dyddiad ar-lein cynnar14 Meh 2022
Dynodwyr Gwrthrych Digidol (DOIs)
StatwsCyhoeddwyd - 02 Hyd 2022
Cyhoeddwyd yn allanolIe

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