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Brief reports: A L McAlister, V Rabius, A Geiger, T J Glynn, P Huang, and R Todd Telephone assistance for smoking cessation: one year cost effectiveness estimations Tob Control 2004; 13: 85-86 [Abstract] [Full text] [PDF]

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Electronic letters published:

The Cost of Recruitment

Nathan K Cobb   (14 June 2004)

Re: The Cost of Recruitment

Anita Lal   (6 December 2005)

The Cost of Recruitment 14 June 2004
Nathan K Cobb, Physician Beth Israel Deaconess Medical Center Send letter to journal: Re: The Cost of Recruitment ncobb{at}bidmc.harvard.edu Nathan K Cobb	McAlister and his co-authors make an extremely valuable contribution to the ongoing debates of health care costs in the form of their estimate of the cost efficacy of a telephone quit line. The publication of this data should provide new evidence to convince payors to cover cessation. However, since recruitment costs were excluded, it is difficult to make broader public health decisions based on these estimates. The decision not to include the costs from a controlled clinical trial is undoubtably correct, as they are not generalizable to larger scale promotion efforts. Most state funded quit lines in operations use multiple outreach methods, including television, radio, print and physician outreach to recruit patients into treatment. To date there have been no estimates published of recruitment costs into these large-scale quit lines, despite the proliferation of state programs. This may be due to the fact that it is difficult to break out costs for recruitment from overall costs for cessation promotion and the normalization of quitting. None the less, until we have concrete estimates of the actual cost to recruit participants into such programs it will be impossible to actually calculate the true cost efficacy.
Re: The Cost of Recruitment 6 December 2005
Anita Lal, Research Officer The Cancer Council Victoria Send letter to journal: Re: Re: The Cost of Recruitment anita.lal{at}cancervic.org.au Anita Lal	Nathan K Cobb raises an important point. This paper has been reviewed by the Centre for Reviews and Dissemination [1], which provides critical assessments of the quality of economic evaluations. They raised this issue along with some other noteworthy points relating to the costs of the program. Specifically, the costs and the quantities were not reported separately, which limits the generalisability of the authors' results. Also, the date to which the prices related was not reported, hindering any possible reflation exercises. The review also reports an error in the cost-effectiveness ratio calculated by the authors. To calculate this ratio the authors divided the average cost per client of the counselling service ($60) by the incremental effect on cessation rates (4.5%). In this incremental analysis, the authors failed to include the costs incurred by patients in the self-help group (i.e. those receiving the booklets only), which amounted to $15 per client. Hence, the incremental cost-effectiveness ratio of the telephone counselling service would be lower than that calculated by the authors, and would be around $1,000 ($45 divided by 4.5%)[1] References 1. Telephone assistance for smoking cessation: one year cost effectiveness estimations [Abstract 20040366] NHS Economic Evaluation Database, available http://nhscrd.york.ac.uk/welcome.htm [2005, 5 December]. Abstract of: Telephone assistance for smoking cessation: one year cost effectiveness estimations, McAlister A, Rabius V, Geiger A, Glynn T, Huang P, Todd R., Tobacco Control, 2004, 13(1):85-86.