Abstract Aims To perform an economic evaluation of a work‐place smoking cessation group training programme with incentives compared with a training programme without incentives. Design A trial‐based cost‐effectiveness analysis (CEA) and cost–utility analysis (CUA) from a societal perspective and an employer's perspective. Setting Sixty‐one companies in the Netherlands. Participants A total of 604 tobacco‐smoking employees. Intervention and comparator A 7‐week work‐place smoking cessation group training programme. The intervention group earned gift vouchers of €350 for 12 months’ continuous abstinence. The comparator group received no incentives. Measurements Online questionnaires were administered to assess quality of life (EQ‐5D‐5 L) and resource use during the 14‐month follow‐up period (2‐month training period plus 12‐month abstinence period). For the CEA the primary outcome measure was carbon monoxide (CO)‐validated continuous abstinence; for the CUA the primary outcome was quality‐adjusted life years (QALY). Bootstrapping and sensitivity analyses were performed to account for uncertainty. Incremental cost‐effectiveness ratio (ICER) tables were used to determine cost‐effectiveness from a life‐time perspective. Findings Of the participants in the intervention group, 41.1% had quit smoking compared with 26.4% in the control group. From a societal perspective with a 14‐month follow‐up period, the ICER per quitter for an intervention with financial incentives compared with no incentives was €11 546. From an employer's perspective, the ICER was €5686. There was no significant difference in QALYs between the intervention and control group within the 14‐month follow‐up period. The intervention was dominated by the comparator in the primary analysis at a threshold of €20 000 per QALY. In the sensitivity analysis, these results were uncertain. A life‐time perspective showed an ICER of €1249 (95% confidence interval = €850–2387) per QALY. Conclusions Financial incentives may be cost‐effective in increasing quitting smoking, particularly from a life‐time perspective.

中文翻译：

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有和没有经济激励措施的工作场所戒烟干预的成本效益和成本效用分析

摘要 目的 对有激励措施的工作场所戒烟小组培训计划与无激励措施的培训计划进行经济评估。从社会角度和雇主角度设计基于试验的成本效益分析 (CEA) 和成本效用分析 (CUA)。在荷兰设立 61 家公司。参与者 共有 604 名吸烟员工。干预和比较 为期 7 周的工作场所戒烟小组培训计划。干预组连续禁欲 12 个月，可获得 350 欧元的礼券。比较组没有得到任何奖励。测量 在线问卷用于评估 14 个月随访期间（2 个月培训期加上 12 个月禁欲期）的生活质量 (EQ-5D-5 L) 和资源使用。对于 CEA，主要结果指标是一氧化碳 (CO) 验证的持续戒断；对于 CUA，主要结果是质量调整生命年 (QALY)。进行引导和敏感性分析以解释不确定性。增量成本效益比 (ICER) 表用于从生命周期的角度确定成本效益。结果 在干预组的参与者中，41.1% 的人戒烟，而对照组的这一比例为 26.4%。从社会角度来看，随访期为 14 个月，与没有激励措施相比，有经济激励措施干预的每位戒烟者的 ICER 为 11 546 欧元。从雇主的角度来看，ICER 为 5686 欧元。在 14 个月的随访期内，干预组和对照组之间的 QALYs 没有显着差异。在主要分析中，干预以每个 QALY 为 20 000 欧元的阈值的比较对象为主。在敏感性分析中，这些结果是不确定的。从生命周期的角度来看，每个 QALY 的 ICER 为 1249 欧元（95% 置信区间 = 850-2387 欧元）。结论 财政激励措施在增加戒烟方面可能具有成本效益，特别是从终生的角度来看。在 14 个月的随访期内，干预组和对照组之间的 QALYs 没有显着差异。在主要分析中，干预以每个 QALY 为 20 000 欧元的阈值的比较对象为主。在敏感性分析中，这些结果是不确定的。从生命周期的角度来看，每个 QALY 的 ICER 为 1249 欧元（95% 置信区间 = 850-2387 欧元）。结论 财政激励措施在增加戒烟方面可能具有成本效益，特别是从终生的角度来看。在 14 个月的随访期内，干预组和对照组之间的 QALYs 没有显着差异。在主要分析中，干预以每个 QALY 为 20 000 欧元的阈值的比较对象为主。在敏感性分析中，这些结果是不确定的。从生命周期的角度来看，每个 QALY 的 ICER 为 1249 欧元（95% 置信区间 = 850-2387 欧元）。结论 财政激励措施在增加戒烟方面可能具有成本效益，特别是从终生的角度来看。