%0 Journal Article
%T Economic evaluation of a brief counselling for smoking cessation in dentistry: a case study comparing two health economic models
%A Inna Feldman
%A Maria R Galanti
%A Pia M Johansson
%A Suvi Erika Virtanen
%J -
%D 2017
%R 10.1136/bmjopen-2017-016375
%X Objectives This study aimed to compare the cost-effectiveness estimates of a brief counselling of smoking cessation in dentistry by using two different health economic models.

Design and outcome measures Intervention effectiveness was estimated in a cluster randomised controlled trial. The number of quitters was estimated based on 7-day abstinence and on smoking reduction at follow-up. Health economic evaluation was performed using two models: (1) a population-based model employing potential impact fractions and (2) a Markov model estimating the cost-effectiveness of the intervention for the actual participants. The evaluation was performed from healthcare and societal perspectives, and health gains were expressed in quality-adjusted life-years (QALYs).

Setting Dental clinics in Sweden.

Participants 205 Swedish smokers aged 20¨C75 years.

Interventions A brief, structured behavioural intervention was compared with ¡®usual care¡¯.

Results The cost per quitter was US$552 in the intervention and US$522 in the ¡®usual care¡¯ condition. The net saving estimated with the population-based model was US$17.3£¿million for intervention and US$49.9£¿million for ¡®usual care¡¯, with health gains of 1428 QALYs and 2369 QALYs, respectively, for the whole Swedish population during 10 years. The intervention was thus dominated by ¡®usual care¡¯. The reverse was true when using the Markov model, showing net societal savings of US$71£¿000 for the intervention and US$57000 for ¡®usual care¡¯, with gains of 5.42 QALYs and 4.74 QALYs, respectively, for lifelong quitters.

Conclusion The comparison of intervention and ¡®usual care¡¯ derived from small-scale studies may be highly sensitive to the choice of the model used to calculate cost-effectiveness.

Trial registration The cluster randomised trial is registered in the ISRCTN register of controlled trials with identification number [ISRCTN50627997][1].

 [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN5062799
%U https://bmjopen.bmj.com/content/7/7/e016375