The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context
Summary: Background: Tailored smoking cessation interventions, which combine behavioural and pharmaceutical support, are effective in populations with severe mental illness (SMI). We establish the cost-effectiveness of two tailored interventions in the UK: (i) a bespoke smoking cessation interventi...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537023000056 |
| _version_ | 1797860347552464896 |
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| author | Richard Mattock Lesley Owen Matthew Taylor |
| author_facet | Richard Mattock Lesley Owen Matthew Taylor |
| author_sort | Richard Mattock |
| collection | DOAJ |
| description | Summary: Background: Tailored smoking cessation interventions, which combine behavioural and pharmaceutical support, are effective in populations with severe mental illness (SMI). We establish the cost-effectiveness of two tailored interventions in the UK: (i) a bespoke smoking cessation intervention (BSCI) versus usual care, and (ii) integrated tobacco cessation and mental health care (IC) versus standard smoking cessation clinic (SCC) referral. Methods: This economic evaluation was conducted between January 15th 2019 and August 4th 2022. We adapted a Markov model estimating smoking status, healthcare costs and quality-adjusted life years (QALYs) across the lifetime. Intervention effectiveness and costs were obtained from a systematic review and a meta-analysis. We obtained specific parameter values for populations with SMI for mortality, risk of smoking related comorbidities, and health utility. Uncertainty was analysed in deterministic and probabilistic sensitivity analysis (PSA). Findings: The BSCI was cost-effective versus usual care with an incremental cost-effectiveness ratio (ICER) of £3145 per QALY (incremental costs: £165; incremental QALYs: 0.05). Integrated care was cost-effective versus SCC with an ICER of £6875 per QALY (incremental costs: £292; incremental QALYs: 0.04). The BSCI and IC were cost-effective in 89% and 83% of PSA iterations respectively. The main area of uncertainty related to relapse rates. Interpretation: Our findings suggested that the tailored interventions were cost-effective and could increase QALYs and decrease expenditure on treating smoking related morbidities if offered to people with SMI. Funding: York Health Economics Consortium was funded by the National Institute for Health and Care Excellence to produce economic evaluations to inform public health guidelines. |
| first_indexed | 2024-04-09T21:45:32Z |
| format | Article |
| id | doaj.art-5b63f28c4eef421c8e1fe8daf7d56f3b |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-09T21:45:32Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-5b63f28c4eef421c8e1fe8daf7d56f3b2023-03-25T05:14:20ZengElsevierEClinicalMedicine2589-53702023-03-0157101828The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in contextRichard Mattock0Lesley Owen1Matthew Taylor2Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; York Health Economics Consortium, University of York, York, UK; Corresponding author. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK.National Institute for Health and Care Excellence, London, UKYork Health Economics Consortium, University of York, York, UKSummary: Background: Tailored smoking cessation interventions, which combine behavioural and pharmaceutical support, are effective in populations with severe mental illness (SMI). We establish the cost-effectiveness of two tailored interventions in the UK: (i) a bespoke smoking cessation intervention (BSCI) versus usual care, and (ii) integrated tobacco cessation and mental health care (IC) versus standard smoking cessation clinic (SCC) referral. Methods: This economic evaluation was conducted between January 15th 2019 and August 4th 2022. We adapted a Markov model estimating smoking status, healthcare costs and quality-adjusted life years (QALYs) across the lifetime. Intervention effectiveness and costs were obtained from a systematic review and a meta-analysis. We obtained specific parameter values for populations with SMI for mortality, risk of smoking related comorbidities, and health utility. Uncertainty was analysed in deterministic and probabilistic sensitivity analysis (PSA). Findings: The BSCI was cost-effective versus usual care with an incremental cost-effectiveness ratio (ICER) of £3145 per QALY (incremental costs: £165; incremental QALYs: 0.05). Integrated care was cost-effective versus SCC with an ICER of £6875 per QALY (incremental costs: £292; incremental QALYs: 0.04). The BSCI and IC were cost-effective in 89% and 83% of PSA iterations respectively. The main area of uncertainty related to relapse rates. Interpretation: Our findings suggested that the tailored interventions were cost-effective and could increase QALYs and decrease expenditure on treating smoking related morbidities if offered to people with SMI. Funding: York Health Economics Consortium was funded by the National Institute for Health and Care Excellence to produce economic evaluations to inform public health guidelines.http://www.sciencedirect.com/science/article/pii/S2589537023000056Cost-effectivenessTobaccoCessationSmokingSevere mental illness |
| spellingShingle | Richard Mattock Lesley Owen Matthew Taylor The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context EClinicalMedicine Cost-effectiveness Tobacco Cessation Smoking Severe mental illness |
| title | The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context |
| title_full | The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context |
| title_fullStr | The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context |
| title_full_unstemmed | The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context |
| title_short | The cost-effectiveness of tailored smoking cessation interventions for people with severe mental illness: a model-based economic evaluationResearch in context |
| title_sort | cost effectiveness of tailored smoking cessation interventions for people with severe mental illness a model based economic evaluationresearch in context |
| topic | Cost-effectiveness Tobacco Cessation Smoking Severe mental illness |
| url | http://www.sciencedirect.com/science/article/pii/S2589537023000056 |
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