Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of the iQUITT study

Amanda L. Graham, Yaojen Chang, Ye Fang, Nathan K. Cobb, David S. Tinkelman, Raymond S. Niaura, David Brian Abrams, Jeanne S. Mandelblatt

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalTobacco Control
Volume22
Issue number6
DOIs
StatePublished - Nov 2013

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Smoking Cessation
Telephone
Internet
Cost-Benefit Analysis
telephone
smoking
Costs and Cost Analysis
costs
evaluation
economics
Intention to Treat Analysis
demographic situation
Counseling
counseling
Smoking

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)

Cite this

Graham, A. L., Chang, Y., Fang, Y., Cobb, N. K., Tinkelman, D. S., Niaura, R. S., ... Mandelblatt, J. S. (2013). Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of the iQUITT study. Tobacco Control, 22(6). https://doi.org/10.1136/tobaccocontrol-2012-050465

Cost-effectiveness of internet and telephone treatment for smoking cessation : An economic evaluation of the iQUITT study. / Graham, Amanda L.; Chang, Yaojen; Fang, Ye; Cobb, Nathan K.; Tinkelman, David S.; Niaura, Raymond S.; Abrams, David Brian; Mandelblatt, Jeanne S.

In: Tobacco Control, Vol. 22, No. 6, 11.2013.

Research output: Contribution to journalArticle

Graham, AL, Chang, Y, Fang, Y, Cobb, NK, Tinkelman, DS, Niaura, RS, Abrams, DB & Mandelblatt, JS 2013, 'Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of the iQUITT study', Tobacco Control, vol. 22, no. 6. https://doi.org/10.1136/tobaccocontrol-2012-050465
Graham, Amanda L. ; Chang, Yaojen ; Fang, Ye ; Cobb, Nathan K. ; Tinkelman, David S. ; Niaura, Raymond S. ; Abrams, David Brian ; Mandelblatt, Jeanne S. / Cost-effectiveness of internet and telephone treatment for smoking cessation : An economic evaluation of the iQUITT study. In: Tobacco Control. 2013 ; Vol. 22, No. 6.
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N2 - 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.

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