Overview and cost-effectiveness of internet-based interventions for smoking cessation in the Netherlands

Abstract

Background: Internet-based smoking cessation interventions have been shown to be effective in enhancing smoking cessation. Yet, it is not clear to what extent these interventions are cost-effective in the Netherlands. This study therefore aimed to (1) provide an overview of internet-based smoking cessation interventions in the Netherlands, and (2) evaluate the cost-effectiveness of adding internet-based interventions to the current practice for smoking cessation. Methods: A mixed-method approach was used to identify the interventions, using scientific literature and grey literature search; and Expert input. A meta-analysis was then performed to determine the effectiveness of a pooled intervention. The EQUIPT return on investment tool was used to calculate the incremental cost-utility ratios (expressed in cost per quality-adjusted life years (QALYs) gained) for different time horizons comparing the current practice with the alternative package (which includes the internet-based intervention). Findings: Many interventions were offered without providing data on the effectiveness, except four six interventions that were included in trials. Four of them, were shown to be effective and cost-effective. The alternative package was dominant in all time horizons (i.e. two years, five years, ten years, and lifetime), with QALYs gained and reduced healthcare costs. Discussion: To our knowledge, this is the first study modelling internet-based smoking cessation interventions in the Netherlands; illustrating cost-effectiveness if added to the current provision of services. However, due to the many internet-based interventions, the smoker is left in bewilderment concerning their efficacy, as most of these data are not available nor offered to the smokers.