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Cost‐effectiveness of a specialist smoking cessation package compared with standard smoking cessation services for people with severe mental illness in England: a trial‐based economic evaluation from the SCIMITAR+ study
Author(s) -
Li Jinshuo,
Fairhurst Caroline,
Peckham Emily,
Bailey Della,
Arundel Catherine,
Hewitt Catherine,
Heron Paul,
Crosland Suzanne,
Parrott Steve,
Gilbody Simon
Publication year - 2020
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15086
Subject(s) - medicine , smoking cessation , schizoaffective disorder , mental health , randomized controlled trial , quality of life (healthcare) , psychiatry , quality adjusted life year , economic evaluation , cost effectiveness , mental illness , nursing , psychosis , risk analysis (engineering) , pathology
Abstract Aims To evaluate the cost‐effectiveness of a specialist smoking cessation package for people with severe mental illness Design Incremental cost‐effectiveness analysis was undertaken from the UK National Health Service and Personal Social Services perspective over a 12‐month time horizon. Total costs, including smoking cessation, health‐care and social services costs and quality‐adjusted life years (QALYs), derived from the five‐level EuroQol 5‐dimension (EQ‐5D‐5 L), collected from a randomized controlled trial, were used as outcome measures. The bootstrap technique was employed to assess the uncertainty. Setting Sixteen primary care and 21 secondary care mental health sites in England. Participants Adult smokers with bipolar affective disorder, schizoaffective disorder or schizophrenia and related illnesses ( n = 526). Intervention and comparator A bespoke smoking cessation (BSC) package for people with severe mental illness offered up to 12 individual sessions with a mental health smoking cessation practitioner versus usual care (UC). Of the participants who were randomized, 261 were in UC group and 265 were in BSC group. Measurements BSC intervention cost was estimated from the treatment log. Costs of UC, health‐care and social services and EQ‐5D‐5 L were collected at baseline, 6‐ and 12‐month follow‐ups. Incremental costs and incremental QLAYs were estimated using regression adjusting for respective baseline values and other baseline covariates. Findings The mean total cost in the BSC group was £270 [95% confidence interval (CI) = –£1690 to £1424] lower than in the UC group, while the mean QALYs were 0.013 (95% CI = –0.008 to 0.045) higher, leading to BSC dominating UC (76% probability of cost‐effective at £20 000/QALY). Conclusions A bespoke smoking cessation package for people with severe mental illness is likely to be cost‐effective over 12 months compared with usual care provided by the UK's National Health Service and personal social services.