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Economic evaluation of a telephone- and face-to-face-delivered counseling intervention for smoking cessation in patients with coronary heart disease


  • Nadine Berndt

    () (Open University of the Netherlands
    Inspection générale de la sécurité sociale, Le Gouvernement du Grand-Duché de Luxembourg)

  • Catherine Bolman

    (Open University of the Netherlands)

  • Lilian Lechner

    (Open University of the Netherlands)

  • Wendy Max

    (University of California, San Francisco)

  • Aart Mudde

    (Open University of the Netherlands)

  • Hein Vries

    (Maastricht University)

  • Silvia Evers

    (Maastricht University
    Netherlands Institute of Mental Health and Addiction)


Abstract Objective This study examined the cost-effectiveness and cost-utility of two smoking cessation counseling interventions differing in their modality for patients diagnosed with coronary heart disease from a societal perspective. Methods In a randomized controlled trial conducted in Dutch hospital wards, cardiac patients who smoked prior to admission were allocated to usual care (n = 245), telephone counseling (n = 223) or face-to-face counseling (n = 157). The counseling interventions lasted for 3 months and were complemented by nicotine patches. Baseline histories were obtained, and interviews took place 6 months after hospitalization to assess self-reported smoking status and quality adjusted life years (QALYs). Incremental cost-effectiveness ratios per quitter and cost-utility ratios per QALY were calculated and presented in acceptability curves. Uncertainty was accounted for by sensitivity analysis. Results Using continued abstinence as the outcome measure showed that telephone counseling had the highest probability of being cost-effective. Face-to-to-face counseling was also more cost-effective than usual care. No significant improvements and differences in QALYs between the three conditions were found. Varying costs and effect estimations revealed that the results of the primary analyses were robust. Conclusions Assuming a willingness-to-pay of €20,000 per abstinent patient, telephone counseling would be a highly cost-effective smoking cessation intervention assisting cardiac patients to quit. However, the lack of consensus concerning the willingness-to-pay per quitter impedes drawing firm conclusions. Moreover, studies with extended follow-up periods are needed to capture late relapses and possible differences in QALYs.

Suggested Citation

  • Nadine Berndt & Catherine Bolman & Lilian Lechner & Wendy Max & Aart Mudde & Hein Vries & Silvia Evers, 2016. "Economic evaluation of a telephone- and face-to-face-delivered counseling intervention for smoking cessation in patients with coronary heart disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 269-285, April.
  • Handle: RePEc:spr:eujhec:v:17:y:2016:i:3:d:10.1007_s10198-015-0677-x
    DOI: 10.1007/s10198-015-0677-x

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    References listed on IDEAS

    1. Elisabeth Fenwick & Bernie J. O'Brien & Andrew Briggs, 2004. "Cost-effectiveness acceptability curves - facts, fallacies and frequently asked questions," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 405-415.
    2. Andrea Manca & Neil Hawkins & Mark J. Sculpher, 2005. "Estimating mean QALYs in trial-based cost-effectiveness analysis: the importance of controlling for baseline utility," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 487-496.
    3. P. Pedram Sendi & Andrew H. Briggs, 2001. "Affordability and cost-effectiveness: decision-making on the cost-effectiveness plane," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 675-680.
    4. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
    5. L. M. Lamers & J. McDonnell & P. F. M. Stalmeier & P. F. M. Krabbe & J. J. V. Busschbach, 2006. "The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1121-1132.
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    More about this item


    Coronary heart disease; Smoking cessation; Quality of life; Telephone counseling; Face-to-face counseling; Economic evaluation;

    JEL classification:

    • I00 - Health, Education, and Welfare - - General - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • Z00 - Other Special Topics - - General - - - General


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