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 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 patients’ mobile phones. A Markov model was used in which patients 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 throughout a patient’s life. Health care and society perspectives (separately) was adopted. Costs taken into account were direct health care costs and direct health care cost and costsfor 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 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.
Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care: economic evaluation of a pragmatic randomised controlled study