3 research outputs found
An examination of user costs in relation to smokers using a cessation service based in the UK
Background: Smoking cessation services provide support to smokers who desire to quit. Published studies to date
have looked at the cost and benefit of service provision but typically focus on clinical trial data. Using routinely
collected observational data, this study examined the costs involved in providing a service in terms of average
health care expenditure per successful quit attempt in addition to population – level cost-effectiveness measures.
Methods: Data were analysed from Quit-51 smoking cessation service across five English regions between March
2013 and March 2016 (n = 9116). For each user, costs were estimated in relation to: (i) time spent with advisers; (ii)
prescription of pharmacotherapy. The total costs compared against self-reported quit at 12 weeks, which represents
the time period for which the service is offered. Cost per quit (CPQ), with 95% confidence interval (CI), was
calculated by relating total expenditure to the number of quitters, firstly for the whole dataset and then by
subgroups of key categorical variables, namely; gender, age group, the Fagerstrom test for nicotine dependence
(FTND) and Index of Multiple Deprivation (IMD). Confidence intervals (CIs) for the mean estimates were derived
using a non-parametric bootstrap procedure. Parameters derived from the calculation in relation to treatment were
used to estimate potential long-term population outcomes under a scenario where the Quit 51 prescription was
rolled out nationally.
Results: The overall mean CPQ for this sample as estimated at 12 weeks was £403.51 (95% CI = £393.36 to £413.76).
The estimated CPQs at this time point were comparable for those aged 12–19 (£423.56, 95% CI = £369.45 to
£492.60) and those aged 20–29 (£430.76, 95% CI = £395.95 to £470.56). Differences were also seen in relation to
other subgroups considered. The treatment parameters translated to a projected increase of 1.5 quality-adjusted life
years (QALYs) per 1000 smokers in the short-term and 23.4 QALYS per 1000 smokers based on a lifetime horizon.
Conclusions: These figures throw light on service expenditure for each successful quit over the timeframe for
which the service is offered in addition to highlighting variability in these costs across different subgroups of the
user population