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Cost-Effectiveness of a Personalised Self-Management Intervention for People Living With Long Covid: The LISTEN
Shaun R S Harris1,2, Bernadette Sewell2, Monica Busse-Morris3
1Swansea Trials Unit, Swansea University, Swansea, UK.
Background:
In the United Kingdom, at least 1.9 million people are estimated to have experienced long Covid, of which 1.3 million have symptoms lasting for more than a year. The Long CovId Personalised Self-managemenT support EvaluatioN (LISTEN) trial evaluated the effectiveness and cost-effectiveness of a co-designed personalised self-management support intervention for non-hospitalised people living with long Covid.
Methods:
We conducted a pragmatic, multicentre, two-arm, parallel group and superiority randomised controlled trial for people who had experienced at least one long Covid symptom for 12 weeks or longer. A cost-utility analysis was undertaken alongside the LISTEN trial from both a UK National Health Service (NHS) and personal social services (PSS) and a societal perspective. Implementation costs were determined from study records, and quality of life and health and care resource use were collected by questionnaire at 6-week and 3-month follow-ups. Incremental net monetary benefit (INMB) analyses evaluated the cost-effectiveness of the intervention at a range of willingness-to-pay thresholds.
Results:
A total of 544 participants were included in the health economic analysis, of which 62.5% had complete data. The average cost of delivering the LISTEN intervention was £846 per participant. At 3-month follow-up, mean quality-adjusted life years (QALYs) were 0.005 (95% CI -0.004 to 0.014) greater for participants receiving the LISTEN intervention compared to usual care. From the NHS and PSS perspective, total adjusted mean costs were £491 (95% CI, £128 to £854) lower in the usual care arm. From the societal perspective, participants in the usual care arm lost more hours of work and usual activities and received more informal care, with the LISTEN intervention dominating usual care.
Conclusions:
At accepted UK thresholds, the LISTEN intervention was not cost-effective from an NHS and PSS perspective, but it was found to be cost-effective from a societal perspective due to the impact of long Covid on work, informal care and usual activities. Further research is required to understand the costs and benefits of self-management support for longer-term horizons.
Patient And Public Contribution:
We are grateful for the contributions of the LISTEN Public and Patient Involvement and Engagement group comprising seven people (Anne Domeney, Ian Patel, Carol Rowe, Judith Parsons, Rebecca Beltran, Elizabeth Treadwell and Maria Ines de Sousa de Abreu) with long Covid who supported co-design, communications, trial recruitment and dissemination activities.
Trial Registration:
ISRCTN36407216, registered 27 January 2022.
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