Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
Department of Research and Development, Epilepsy Center Kempenhaeghe, Heeze, the Netherlands.
Addiction. 2018 Jun;113 Suppl 1(Suppl Suppl 1):87-95. doi: 10.1111/add.14069. Epub 2017 Dec 15.
The cost-effectiveness of internet-based smoking cessation interventions is difficult to determine when they are provided as a complement to current smoking cessation services. The aim of this study was to evaluate the cost-effectiveness of such an alternate package compared with existing smoking cessation services alone (current package).
A literature search was conducted to identify internet-based smoking cessation interventions in the Netherlands. A meta-analysis was then performed to determine the pooled effectiveness of a (web-based) computer-tailored intervention. The mean cost of implementing internet based interventions was calculated using available information, while intervention reach was sourced from an English study. We used EQUIPTMOD, a Markov-based state-transition model, to calculate the incremental cost-effectiveness ratios [expressed as cost per quality-adjusted life years (QALYs) gained] for different time horizons to assess the value of providing internet-based interventions to complement the current package.). Deterministic sensitivity analyses tested the uncertainty around intervention costs per smoker, relative risks, and the intervention reach.
Internet-based interventions had an estimated pooled relative risk of 1.40; average costs per smoker of €2.71; and a reach of 0.41% of all smokers. The alternate package (i.e. provision of internet-based intervention to the current package) was dominant (cost-saving) compared with the current package alone (0.14 QALY gained per 1000 smokers; reduced health-care costs of €602.91 per 1000 smokers for the life-time horizon). The alternate package remained dominant in all sensitivity analyses.
Providing internet-based smoking cessation interventions to complement the current provision of smoking cessation services could be a cost-saving policy option in the Netherlands.
当互联网戒烟干预措施作为当前戒烟服务的补充提供时，其成本效益很难确定。本研究旨在评估与单独提供当前戒烟服务（现行方案）相比，这种替代方案的成本效益。
我们进行了文献检索，以确定荷兰的互联网戒烟干预措施。然后，我们进行了荟萃分析，以确定（基于网络的）计算机量身定制干预措施的综合效果。我们使用了可用信息来计算实施互联网干预措施的平均成本，而干预范围则来源于一项英国研究。我们使用了基于马尔可夫模型的状态转换模型 EQUIPTMOD，以计算不同时间范围内的增量成本效益比（表示为每获得一个质量调整生命年的成本），以评估为补充现行方案而提供互联网干预措施的价值。确定性敏感性分析测试了干预成本、相对风险和干预范围的不确定性。
互联网干预措施的估计综合相对风险为 1.40；每个吸烟者的平均成本为 2.71 欧元；覆盖的吸烟者比例为 0.41%。与单独提供现行方案相比，替代方案（即在现行方案中提供互联网干预措施）具有优势（成本节约），每个吸烟者获得 0.14 个 QALY（终生范围内，每个吸烟者的医疗保健成本降低 602.91 欧元）。在所有敏感性分析中，替代方案均保持优势。
在荷兰，提供互联网戒烟干预措施来补充当前的戒烟服务提供，可能是一种节约成本的政策选择。
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