Cost-Effectiveness of Four Financial Incentive Programs for Smoking Cessation.

Area of Science:

• Health Economics
• Public Health Interventions
• Smoking Cessation

Background:

• Financial incentive programs have demonstrated effectiveness in promoting sustained smoking abstinence.
• The high upfront costs of these incentive programs can be a barrier to employer adoption.
• Cost-effectiveness data is crucial for evaluating the broader implementation of such programs.

Purpose of the Study:

• To evaluate the cost-effectiveness of four financial incentive programs for smoking cessation.
• To analyze costs from both the healthcare sector and employer perspectives.
• To inform decisions regarding the adoption of employer-sponsored smoking cessation initiatives.

Main Methods:

• A decision model was developed using data from a trial at CVS Caremark and supplementary literature.
• Life-expectancy gains were projected using U.S. life tables.
• Program designs included individual and group-oriented incentives, with some requiring participant deposits.

Main Results:

• From the healthcare sector perspective, costs ranged from $3,200/life-year ($2,500/QALY) to $6,500/life-year ($5,100/QALY).
• From the employer perspective, costs ranged from $256,600/life-year gained to $1,711,100/life-year gained.
• Cost-effectiveness improved for employers with longer decision horizons and decreased when including future medical costs.

Conclusions:

• Financial incentive programs for smoking cessation are highly cost-effective from the healthcare sector viewpoint.
• These programs are more costly for employers but can be cost-effective under specific conditions, such as longer decision horizons.
• The findings support the consideration of financial incentives as a viable strategy for promoting smoking cessation.