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

Jinshuo Li; Caroline Fairhurst; Emily Peckham; Della Bailey; Catherine Arundel; Catherine Hewitt; Paul Heron; Suzanne Crosland; Steve Parrott; Simon Gilbody; SCIMITAR+ collaborative

doi:10.1111/add.15086

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

Jinshuo Li^*, Caroline Fairhurst, Emily Peckham, Della Bailey, Catherine Arundel, Catherine Hewitt, Paul Heron, Suzanne Crosland, Steve Parrott, Simon Gilbody, SCIMITAR+ collaborative

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

15 Downloads (Pure)

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.

Original language	English
Pages (from-to)	2113-2122
Number of pages	10
Journal	Addiction
Volume	115
Issue number	11
Early online date	22 Apr 2020
DOIs	https://doi.org/10.1111/add.15086
Publication status	Published - Nov 2020
Externally published	Yes

Keywords

Cost-effectiveness
cost–utility
economic evaluation
severe mental illness
smoking cessation
tobacco use

ASJC Scopus subject areas

Medicine (miscellaneous)
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Documents and Links

10.1111/add.15086

Final published versionFinal published version, 1.71 MBLicence: CC BY

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Li, J., Fairhurst, C., Peckham, E., Bailey, D., Arundel, C., Hewitt, C., Heron, P., Crosland, S., Parrott, S., Gilbody, S., & SCIMITAR+ collaborative (2020). 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. Addiction, 115(11), 2113-2122. https://doi.org/10.1111/add.15086

@article{43202b98a32647fb92dbb6dba2f8b19e,

title = "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",

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.",

keywords = "Cost-effectiveness, cost–utility, economic evaluation, severe mental illness, smoking cessation, tobacco use",

author = "Jinshuo Li and Caroline Fairhurst and Emily Peckham and Della Bailey and Catherine Arundel and Catherine Hewitt and Paul Heron and Suzanne Crosland and Steve Parrott and Simon Gilbody and Tim Bradshaw and Michelle Horspool and Elizabeth Hughes and Suzy Ker and Moira Leahy and Tayla McCloud and David Osborn and Thomas Steare and Emma Ballantyne and Polly Bidwell and Sue Bonner and Diane Brennan and Tracy Callen and Charlotte Colbeck and Debbie Coton and Emma Donaldson and Hannah Herlihy and Lizwi Nyathi and Elizabeth Nyamadzawo and Helen Oldknow and Peter Phiri and Shanaya Rathod and Jamie Rea and Alison Stribling and Carinna Vickers and Tom Hughes and Joe Reilly and Alex Carey and Kimberley Evans and Wajid Khan and Crystal-Bella Romain-Hooper and Kaye Smith and {SCIMITAR+ collaborative}",

note = "Funding Information: This trial is dedicated to the memory of Professor Helen Lester (1961–2013), who collaborated on the early stages of the SCIMITAR+ trial, and is a celebration of her work and contribution to the care and wellbeing of people with severe mental ill health. This was her abiding passion and will be her lasting contribution. We would like to thank the participants for taking part in the trial, the GPs and secondary and tertiary care staff for recruiting participants to the study and completing trial documentation, the Trial Steering Committee and Data Monitoring and Ethics Committee members for overseeing the study. We acknowledge the support and advice of Dr Andy McKewan, Director of the National Centre for Smoking Cessation and Training for their advice on the use of evidence supported smoking cessation interventions and their adaptation to people with severe mental ill health. This trial was funded by NIHR Health Technology Assessment Programme (project number or ref. 11/136/52). S.G., S.P. and M.L. were funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH), www.clahrc-yh.nihr.ac.uk. The funder of this study had no role in study design, data collection, data analysis, data interpretation or writing of the report. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.",

year = "2020",

month = nov,

doi = "10.1111/add.15086",

language = "English",

volume = "115",

pages = "2113--2122",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "11",

}

Li, J, Fairhurst, C, Peckham, E, Bailey, D, Arundel, C, Hewitt, C, Heron, P, Crosland, S, Parrott, S, Gilbody, S & SCIMITAR+ collaborative 2020, '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', Addiction, vol. 115, no. 11, pp. 2113-2122. https://doi.org/10.1111/add.15086

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. / Li, Jinshuo; Fairhurst, Caroline; Peckham, Emily et al.
In: Addiction, Vol. 115, No. 11, 11.2020, p. 2113-2122.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - 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

AU - Li, Jinshuo

AU - Fairhurst, Caroline

AU - Peckham, Emily

AU - Bailey, Della

AU - Arundel, Catherine

AU - Hewitt, Catherine

AU - Heron, Paul

AU - Crosland, Suzanne

AU - Parrott, Steve

AU - Gilbody, Simon

AU - Bradshaw, Tim

AU - Horspool, Michelle

AU - Hughes, Elizabeth

AU - Ker, Suzy

AU - Leahy, Moira

AU - McCloud, Tayla

AU - Osborn, David

AU - Steare, Thomas

AU - Ballantyne, Emma

AU - Bidwell, Polly

AU - Bonner, Sue

AU - Brennan, Diane

AU - Callen, Tracy

AU - Colbeck, Charlotte

AU - Coton, Debbie

AU - Donaldson, Emma

AU - Herlihy, Hannah

AU - Nyathi, Lizwi

AU - Nyamadzawo, Elizabeth

AU - Oldknow, Helen

AU - Phiri, Peter

AU - Rathod, Shanaya

AU - Rea, Jamie

AU - Stribling, Alison

AU - Vickers, Carinna

AU - Hughes, Tom

AU - Reilly, Joe

AU - Carey, Alex

AU - Evans, Kimberley

AU - Khan, Wajid

AU - Romain-Hooper, Crystal-Bella

AU - Smith, Kaye

AU - SCIMITAR+ collaborative

N1 - Funding Information: This trial is dedicated to the memory of Professor Helen Lester (1961–2013), who collaborated on the early stages of the SCIMITAR+ trial, and is a celebration of her work and contribution to the care and wellbeing of people with severe mental ill health. This was her abiding passion and will be her lasting contribution. We would like to thank the participants for taking part in the trial, the GPs and secondary and tertiary care staff for recruiting participants to the study and completing trial documentation, the Trial Steering Committee and Data Monitoring and Ethics Committee members for overseeing the study. We acknowledge the support and advice of Dr Andy McKewan, Director of the National Centre for Smoking Cessation and Training for their advice on the use of evidence supported smoking cessation interventions and their adaptation to people with severe mental ill health. This trial was funded by NIHR Health Technology Assessment Programme (project number or ref. 11/136/52). S.G., S.P. and M.L. were funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH), www.clahrc-yh.nihr.ac.uk. The funder of this study had no role in study design, data collection, data analysis, data interpretation or writing of the report. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

PY - 2020/11

Y1 - 2020/11

N2 - 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.

AB - 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.

KW - Cost-effectiveness

KW - cost–utility

KW - economic evaluation

KW - severe mental illness

KW - smoking cessation

KW - tobacco use

U2 - 10.1111/add.15086

DO - 10.1111/add.15086

M3 - Article

C2 - 32319154

AN - SCOPUS:85085874603

SN - 0965-2140

VL - 115

SP - 2113

EP - 2122

JO - Addiction

JF - Addiction

IS - 11

ER -