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[null,null,null,null,"Health Economics Evidence Resource"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"v2.0"]
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[null,null,null,null," Introduction"]
[null,null,null,null," Pages in this tool"]
[null,null,null,null,"  • Introduction",null,">>","Overview of the tool"]
[null,null,null,null,"  • User Guide",null,">>","Instructions and guidance on how to use the tool"]
[null,null,null,null,"  • Evidence",null,">>","Contains economic evidence"]
[null,null,null,null,"  • Further Information",null,">>","Further information about the tool"]
[null,null,null,null,"  • Glossary",null,">>","Glossary of economic terms"]
[null,null,null,null,"  • Sources",null,">>","List of secondary sources used to select evidence"]
[]
[null,null,null,null," Health Economics Evidence Resource"]
[null,null,null,null,"  • The Health Economics Evidence Resource (HEER) provides an initial snapshot collection of economic evidence underpinning public health interventions."]
[null,null,null,null,"  • It builds on PHE's Menu of Interventions, including evidence not limited by savings over a specific timeframe or by who benefits from the intervention.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Menu of Interventions"]
[null,null,null,null,"  • It is not a systematic review of the evidence; this is a summary of evidence from other reviews and has been created internally within PHE.  It is an ‘agile’ resource which will be updated"]
[null,null,null,null,"    and expanded over time."]
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[null,null,null,null," Target audience"]
[null,null,null,null,"  • Internal PHE staff and those working in public health in local authorities and the NHS, who want to quickly and easily understand the economic evidence in a particular area."]
[null,null,null,null,"  • Analysts, registrars, consultants, commissioners, directors of public health."]
[]
[null,null,null,null," Coverage"]
[null,null,null,null,"  • The HEER provides evidence for interventions across 13 areas within public health:"]
[null,null,null,null,"  • Sexual Health Services; NHS Health Check Programme; Health Protection; Obesity & Physical Activity; Alcohol Misuse; Drug Misuse; Smoking & Tobacco; The Healthy Child Programme;"]
[null,null,null,null,"    (HCP) 0-5; The Healthy Child Programme (HCP) 5-19; Mental Health; Cardiovascular Disease; MSK & Falls; Miscellaneous"]
[]
[null,null,null,null," Types of economic evidence included"]
[null,null,null,null,"  • It includes interventions that are cost-effective (defined by the HEER as below the NICE cost per QALY threshold of £20,000-£30,000), not cost-effective and those that are cost-saving "]
[null,null,null,null,"    or give a return on investment. For more information on the types of economic analysis, see the following link (section 6.3).",null,null,null,null,null,null,null,null,null,null,"NICE types of economic analysis"]
[null,null,null,null,"  • As a tool that focuses on local delivery, it contains localised cost-effectiveness evidence (with the exception of vaccination evidence which, by nature, requires extensive coverage at a"]
[null,null,null,null,"    national level in order to be cost-effective) and excludes interventions implementable at a national level. "]
[null,null,null,null,"  • Evidence published prior to 1995 has been excluded."]

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[null,null,null,null,"Health Economics Evidence Resource"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"v2.0"]
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[]
[]
[]
[null,null,null,null," User Guide"]
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[]
[]
[]
[]
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[]
[]
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[null,null,null,null," Interacting with the resource:"]
[null,null,null,null,"  • the chevron pages along the top can be used to switch between pages"]
[null,null,null,null,"  • the green buttons allow the user to interact with the resource"]
[]
[null,null,null,null," How to use the resource"]
[null,null,null,null," To search evidence (for example, \"I'm interested in looking at the economic evidence for "]
[null,null,null,null," sexual health services\")",null,":"]
[null,null,null,null,"  • browse 'Evidence' tab and use filter buttons (click the drop-down arrows in row 1 above"]
[null,null,null,null,"     each column) to review a subset of the interventions"]
[null,null,null,null,"  • click on each heading (row 1) to understand the type of information in each column and"]
[null,null,null,null,"    guidance on how to interpret it"]
[null,null,null,null,"  • you can filter 'Theme' by 'Sexual Health, Reproductive Health and HIV', or refine selection"]
[null,null,null,null,"    further by filtering on 'Activity' or  economic evidence (eg BCR, ICER, cost saving evidence)"]
[null,null,null,null,"  • you can also use the \"Ctrl + F\" function to search for key words (eg HIV, contraception)"]
[]
[null,null,null,null," To produce PDF reports of selected interventions (see example report):"]
[null,null,null,null,"  • press \"Clear Selection\" to clear any previously selected interventions and prior filters"]
[null,null,null,null,"  • select topics or activities of interest, by changing cells from \"No\" to \"Yes\" in the 'Select for"]
[null,null,null,null,"    PDF report' column"]
[null,null,null,null,"  • when you have finished, click on \"Produce PDFs of my selection\""]
[null,null,null,null,"  • save these PDFs for further viewing"]
[]
[]
[null,null,null,null," To clear selection of interventions:"]
[null,null,null,null,"  • click on \"Clear my selection\""]
[]
[]
[null,null,null,null," To ask questions and / or share evidence that has not been included:"]
[null,null,null,null,"  • click on \"Email us\""]
[null,null,null,null," To provide feedback on the resource:"]
[null,null,null,null,"  • click on \"Feedback Survey\""]

{"sheet":"Evidence","index":2,"n_rows":373,"n_cols":25,"rows_kept":373,"cut":false,"hidden":false,"merged":[]}
["ID","Theme","Activity","Intervention","Select for report","Benefit-cost ratio (BCR)"," ICER","Cost saving evidence","Summary of evidence","Type of analysis","Type of evidence","Study population","Comparator","Assumptions / Caveats","Timeframe","Who pays?","Key outcome measure of evidence","Country","Discount rate","Currency","Publication year","Reference to original source","Link to original source","Further information","Year evidence was added to HEER"]
["A1","Sexual Health, Reproductive Health and HIV","Contraception","Contraception","No","£11.09: £1","-","-","£1 invested in contraception saves £11.09 in averted outcomes.","Cost-benefit analysis","Published report","-","No intervention","Averted outcomes = healthcare costs saved due to unplanned pregnancies avoided (in terms of terminations, antenatal and maternity care).","-","LA","NHS savings","England","-","£ GBP",2013,"Bayer HealthCare. Contraception Atlas. 2013.","Link to source","-",2017]
["A2","Sexual Health, Reproductive Health and HIV","Contraception","Contraception","No","-",4965,"-","School based group education for increasing rates of condom use and reducing STIs and unwanted pregnancy.\nThe intervention involved weekly lessons following a health curriculum that highlights the impacts of drug and alcohol\nuse, violence and sexual behaviour on health. The curriculum was developed throughout with input from students,\nteachers and parents. Teaching staff were trained to deliver the program.","Cost-utility analysis","Published report","Sexually active 11-16 year olds.","No intervention","Cost: £157.15 per person. Reference rated the quality of evidence as low.\nOutcomes: 9.36% increase in use of condoms, which provided an additional 0.156 QALYs and £934 cost savings from reduced transmission of chlamydia and associated complications, such as pelvic inflammatory disease [PID] and ectopic pregnancy). Benefits are assumed to occur 5 years or more after intervention.","7 years","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. 2009.","Link to source","-",2017]
["A3","Sexual Health, Reproductive Health and HIV","Contraception","LARC methods","No","£13.42:£1","-","-","£1 invested in LARC methods of contraception saves £13.42 in averted outcomes.","Cost-benefit analysis","Published report","-","No intervention","LARC = long-acting reversible contraception\nAverted outcomes = healthcare costs saved due to unplanned pregnancies avoided (in terms of terminations, antenatal and maternity care).","-","LA","NHS savings","England","-","£ GBP",2013,"Bayer HealthCare. Contraception Atlas. 2013.","Link to source","-",2017]
["A4","Sexual Health, Reproductive Health and HIV","Contraception","LARC methods","No","-",13206,"-","The incremental cost-effectiveness ratio of implant (most effective LARC method) versus IUD (cheapest LARC method) was £13 206 per unintended pregnancy averted for 1 year of use and decreased until implant dominated IUD in 15 years. \n\nLARC methods dominated combined oral contraceptive pill (COC).","Cost-utility analysis","Published academic journal","-","Intervention - IUD","LARC = long-acting reversible contraception\nIUD = intrauterine device (coil)\n\nCosts of contraceptive provisions considered against costs associated with outcomes of unintended pregnancy.\n\nThe economic analysis considered consecutive time frames from 1 to 15 years of intended contraceptive use to explore the changes in the relative cost-effectiveness of LARC methods over time. \n\nDiscontinuation was a key determinant of the cost-effectiveness of LARC methods, as outcomes expressed in terms of results from initiated method plus averaged of method adopted after discontinuation.","See assumptions","LA","NHS savings","England",3.5000000000000003E-2,"£ GBP 2005",2008,"Mavranezouli I. The cost-effectiveness of long-acting reversible contraceptive methods in the UK: analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline. Human Reproduction. 2008;23(6):1338-45.","Link to source","-",2017]
["A5","Sexual Health, Reproductive Health and HIV","Contraception","LARC methods","No","-","-","£143 per woman","Switching from oral contraceptive pill to LARCs is estimated to save £29 per annum per woman (£143 over 5 years) through avoided unplanned pregnancies.","Cost-effectiveness analysis","Primary PHE modelling","Savings estimated, based on 1000 women switching from oral contraceptive to LARCs","Intervention - oral contraceptive pill.","LARC = long-acting reversible contraception.\nLARCs are non-user dependent and 99.9% effective in preventing unwanted pregnancy compared to 92% for the contraceptive pill (typical use) or 82% for the male condom (typical use).\n\nCost around c£12 p.a. per woman moving to LARC over 5 years (£514 LARC, £211 in year 1, £74 each year thereafter; £456 oral contraceptive pill)\n\nDoes not include impact of backfilling healthcare professionals on training (£8 per annum per woman, of which £4 NHS costs).","5 years","LA","NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","Based on evidence from evaluations conducted by NICE (CG30)",2017]
["A6","Sexual Health, Reproductive Health and HIV","Contraception","Contraception","No","£9.00:£1","-","-","Economic values based on PHE's Contraceptive services ROI tool. The model estimates the ROI for publicly funded contraception in England. The 'benefits' can be regarded as the healthcare and non-healthcare cost savings that result from averting conceptions. This scenario examines what the ROI would be if LARCs were replaced by people privately purchasing the pill and condom equally. ","Cost-benefit analysis","Primary PHE modelling","Women of child-bearing age (15 to 44 year old) in England ","Publically funded contraception and current pattern of contraception remains","Default scenario applied:\nScenario 1/5 - LARCs replaced by pill and condom equally\nPerspective selection - Total public sector\nTime horizon - 10 years\n\nAlthough women aged over 44 are often still fertile and capable of childbearing, women aged 15 to 44 represent the majority of conceptions in England.\n\n60% of unplanned births are mistimed. \n\nCosts are discounted at 3.5%\n\n","10 years","Local authority and NHS","Cost savings from pregnancies averted","England",3.5000000000000003E-2,"£ GBP",2018,"PHE Contraceptive services ROI tool","link to source","McGuire A, Hughes D. The economics of family planning services: a report prepared for the Contraceptive Alliance. FPA Fam Plan Assoc. 1995.","2019"]
["A7","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Teenage pregnancy","No","£11:£1","-","-","Every £1 spent preventing teenage pregnancy saves £11 in health care costs (abortion, antenatal and maternity costs).","Cost-benefit analysis","Published report","-","-","-","-","LA","NHS savings","England","-","£ GBP",2011,"Teenage Pregnancy Associates. Teenage Pregnancy: The Evidence 2012.","Link to source","Further reference (Kings Fund)",2017]
["A8","Sexual Health, Reproductive Health and HIV","HIV Testing","Expanded HIV testing","No","$1.46 - $2.01","-","-","The Expanded HIV Testing Initiative is intervention focused on providing HIV testing to disproportionately affected populations. This intervention resulted in a return of $1.95 for every $1 dollar invested, ranging from $1.46 to $2.01 (BCR).","Cost-benefit analysis","Published Academic Journal","Populations disproportionately affected by HIV including MSM, black and Hispanic.","No Intervention","The BCR is described as an ROI in the original paper. The benefits include averted HIV transmission and medical costs. Lifetime HIV costs are valued at $367,134 in 2009 USD. This intervention tested 2.7 million people with a HIV positive rate of 0.7% and an estimated 3381 infections were avoided. The range of $1.46 to $2.01 covers a testing interval of 1-5 years.","Lifetime","-","Benefit-Cost Ratio","USA",0.03,"$ USD 2009",2012,"Hutchinson AB, Farnham PG, Duffy N, et al. Return on public health investment:\nCDC’s expanded HIV testing initiative. J Acquir Immune Defic Syndr 2012;59:281–6.","Link to Source","-",2019]
["A9","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Accelerated partner therapy","No","-",14025,"-","Accelerated partner therapy - doxycycline\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.\n\nCost / QALY is median estimate based on 2 estimates ranging from, £9,350-£18,700.","Cost-utility analysis","Published academic journal","-","Intervention: Patient referral","The incremental analysis demonstrated that brief interventions involving information giving or developing motivation and behavioural skills (particularly among women) produce the greatest benefits for the least cost. More intensive behavioural skills counselling and enhanced counselling appear to be least cost effective. These analyses apply to the general population, including vulnerable young women.\n\nIn the absence of data, no costs were attributed to 'usual treatment'. As a result, when interventions are compared against usual treatment the cost difference may be overestimated and the incremental cost-effectiveness ratios may be artificially high.\n\nThe loss of quality of life (QALYs lost) is particularly important in the analysis. The cost per QALY may be high (if low values are assigned to the change in quality of life) but brief STI counselling falls below a £30,000 per QALY threshold (based on 0.1 of a QALY change).","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A10","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Accelerated partner therapy","No","-",19425,"-","Accelerated partner therapy - azithromycin.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.\n\nCost / QALY is median estimate based on 2 estimates ranging from, £12,950–£25,900.","Cost-utility analysis","Published academic journal","-","Intervention: Patient referral","(1) Cost per 1,000 people receiving intervention = £38,850, cost / QALY = £12,950\n(2) Cost per 1,000 people receiving intervention = £51,800, cost / QALY = £25,900","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A11","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",3200,"-","Tailored skill session.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.","Cost-utility analysis","Published academic journal","-","Intervention: Usual care - didactic messages (instructive method of teaching)","Per 1,000 people receiving the intervention:\nCost: £16,000\nOutcomes: 50 STI infection averted, 5 QALYs gained","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A12","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",10286,"-","Information and behaviour skills.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.","Cost-utility analysis","Published academic journal","-","Intervention: Didactic information (instructive method of teaching)","Per 1,000 people receiving the intervention:\nCost: £72,000\nOutcomes: 70 STI infection averted, 7 QALYs gained","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A13","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",12194,"-","Brief counselling.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.\n\nCost / QALY is median estimate based on 2 estimates ranging from, £12,308-£12,080.","Cost-utility analysis","Published academic journal","-","Intervention: Didactic messages (instructive method of teaching)","Per 1,000 people receiving the intervention:\nCost: £32,000\nOutcomes: 26 STI infection averted, 3 QALYs gained","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A14","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",14143,"-","Information, motivation and behaviour skills counselling.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.\n\nCost / QALY is median estimate based on 2 estimates ranging from, £10,286-£18,000.","Cost-utility analysis","Published academic journal","-","Intervention: Didactic information (instructive method of teaching)","Per 1,000 people receiving the intervention (for 2 estimates - £10,286 / QALY):\nCost: £72,000\nOutcomes: 70 STI infection averted, 3 QALYs gained\n\nPer 1,000 people receiving the intervention (for 1 estimate - £18,000 / QALY):\nCost: £72,000\nOutcomes: 40 STI infection averted, 4 QALYs gained.","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A15","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",24000,"-","Intensive counselling.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.","Cost-utility analysis","Published academic journal","-","Intervention: Treatment as usual","Per 1,000 people receiving the intervention:\nCost: £96,000\nOutcomes: 40 STI infection averted, 4 QALYs gained","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A16","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",45606,"-","Enhanced counselling.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.\n\nCost / QALY is median estimate based on 2 estimates ranging from, £39,600–£51,613.","Cost-utility analysis","Published academic journal","-","Intervention: Didactic messages (instructive method of teaching)","Per 1,000 people receiving the intervention (for 1 estimate - £39,600 / QALY):\nCost: £158,400\nOutcomes: 40 STI infection averted, 4 QALYs gained\n\nPer 1,000 people receiving the intervention (for 1 estimate - £51,613 / QALY):\nCost: £160,000\nOutcomes: 31 STI infection averted, 3 QALYs gained.","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A17","Sexual Health, Reproductive Health and HIV","Sexual health advice, promotion and prevention activities","Counselling","No","-",96000,"-","Behavioural skills counselling.\n\nBenefits measured in prevention of sexually transmitted infections and under 18 conceptions.","Cost-utility analysis","Published academic journal","399 patients; n=199 (intervention); n=200 (treatment as usual)","Intervention - standard 15 minute risk reduction\ncounselling ","Per 1,000 people receiving the intervention:\nCost: £192,000\nOutcomes: 20 STI infection averted, 2 QALYs gained","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"NERA Economic Consulting. Economic Modelling of Interventions to Reduce the Transmission of Chlamydia and other Sexually Transmitted Infections and to Reduce the Rate of Under Eighteen Conceptions. A Final Report for the National Institute for Health and Clinical Excellence 2006.","Link to source","Based on evidence from evaluations conducted by NICE (PH3)",2017]
["A18","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","-","Cost-effective","Cost-saving","HIV services for patients diagnosed early is cost-effective (cost per life year gained of £1,776). Early diagnosis provides better outcomes for cart treatment and is cost-effective (£4,639 per life year gained).\n\nCost savings accrue due to prevented onward HIV transmission and reduced, expensive late diagnosis.","Cost-effectiveness analysis","Published academic journal","n=5,858","Intervention - late diagnosis","cart = combination antiviral therapy\nEarly / late diagnosis definitions based on CD4 count (late: <200 cells/mm3; early >=200 cells/mm3).\n\nCare costs for late stage diagnosis have been estimated at £12,800 per annum per patient; care costs for early diagnosis £10,500.\n\nA diagnosis of HIV can reduce onward transmission through treatment and changes in behaviour. Individuals diagnosed with HIV infection demonstrated a reduction in risk behaviour, which has been shown to contribute to a reduced rate of onward transmission.\n\nEarlier diagnosis leads to better outcomes from cart and lower costs (early diagnosis:£2,758, late diagnosis: £6,407).\n\nMenu of Interventions estimates savings of £278 million by increasing HIV screening as above (based on primary modelling).","10 years","LA","NHS savings, better health outcomes for patients, lower onward transmission","England",0.03,"£ GBP 2008",2011,"Beck EJ, Mandalia S, Sangha R, Sharott P, Youle M, Baily G, et al. The Cost-Effectiveness of Early Access to HIV Services and Starting cart in the UK 1996–2008. PLOS ONE. 2011;6(12):e27830.","Link to source","Evidence included in Menu of Interventions",2017]
["A19","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","-",17500,"-","Targeted annual HIV testing (annual testing for men who have sex with men (MSM), people who inject drugs (PWID), people from HIV-endemic countries and one-time testing to other adults) prevents infections and requires less tests to diagnose people living with HIV.","Cost-effectiveness analysis","Published academic journal","Modelled adult population (15-64) with risk status for HIV prevalence and incidence","Intervention - status quo (current testing and treatment levels)","4-15% of new infections averted. A quarter as many tests are required to diagnose people living with HIV.£0.75 per test; 42,900 QALYs gained.","10 years","LA","NHS savings, QALY gains for service users","England",0.03,"£ GBP 2012",2014,"Long EF, Mandalia R, Mandalia S, Alister SS, Beck EJ, Brandeau ML. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom. PLOS ONE. 2014;9(4):e95735.","Link to source","-",2017]
["A20","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","-",26800,"-","Targeted annual HIV ( (annual testing for men who have sex with men (MSM), people who inject drugs (PWID), people from HIV-endemic countries and one-time testing to other adults) and anti-retroviral therapy (ART) access prevents infections and requires less tests to diagnose people living with HIV.","Cost-effectiveness analysis","Published academic journal","Modelled adult population (15-64) with risk status for HIV prevalence and incidence","Intervention - status quo (current testing and treatment levels)","23% of new infections averted. £0.75 per test; 145,000 QALYs gained.","10 years","LA","NHS savings, QALY gains for service users","England",0.03,"£ GBP 2012",2014,"Long EF, Mandalia R, Mandalia S, Alister SS, Beck EJ, Brandeau ML. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom. PLOS ONE. 2014;9(4):e95735.","Link to source","-",2017]
["A21","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","-","Cost-effective","Cost-saving","For MSM (men who have sex with men), HIV testing was cost saving for 6-month compared with annual testing and cost-saving or cost-effective for quarterly compared with 6-month testing using either test. \n\nTesting IDU (injection drug users)  was not cost effective under NICE threshold.\n\nFourth-generation tests are more sensitive and generally more cost-effective than rapid point-of-care tests.","Cost-effectiveness analysis","Published academic journal","Mathematical model based on cohorts of 10,000 MSM and IDU.","Intervention - HIV testing frequencies","See reference for full set of scenario results and assumptions. Two presented below as an example.\n\n(a) 6 month compared to annual test: 2 additional infections averted at a cost of $519k, saving $834k in treatment costs and  providing 8.9 additional QALYs.\n(b) 3 month compared to 6 months:\n1.2 additional infections averted at a cost of $350k, saving $499k in treatment costs and  providing 5.33 additional QALYs.\n\nMSM results remained robust in sensitivity analysis and type of HIV test used (fourth-generation and rapid point-of-care tests).","1 year","LA","Healthcare savings, QALY gains for service users","USA",0.03,"$ USD 2012",2016,"Hutchinson AB, Farnham PG, Sansom SL, Yaylali E, Mermin JH. Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States. Journal of Acquired Immune Deficiency Syndromes (1999). 2016;71(3):323-30.","Link to source","-",2017]
["A22","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","$1.95: $1","-","-","For every $1 spent on HIV prevention, there was a return of $1.95  based on total HIV investment, including expanded HIV service which focused 80% of resource on high morbidity clinical setting testing and 20% on testing high-risk populations in nonclinical settings . \n\nROI ranged from $1.46 to $2.01 for alternative testing intervals of 1-5 years and remained above $1 (positive return on investment) with a prevalence of undiagnosed HIV infection as low as 0.12%.","Cost-benefit analysis","Published academic journal","2.7 million people tested for HIV","Intervention - later diagnosis (3 years)","\nTotal cost = $599m\nTotal benefits = $1,170 (averted medical costs).\n2.7 million persons were tested for HIV over 3 years, there was a newly diagnosed HIV positivity rate of 0.7%, and an estimated 3,381 HIV infections were averted. \n$367,134 = lifetime HIV treatment cost (used for each transmission averted).","3 years","LA","Healthcare savings, lower onward transmission","USA",0.03,"$ USD 2009",2012,"Hutchinson AB, Farnham PG, Duffy N, Wolitski RJ, Sansom SL, Dooley SW, et al. Return on Public Health Investment: CDC's Expanded HIV Testing Initiative. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2012;59(3):281-6.","Link to source","-",2017]
["A23","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","HIV testing","No","-","£67,000-£106,000","-","Universal HIV testing is not cost-effective under NICE cost-effectiveness threshold. This outcome does not change with less frequent testing (every 2 / 3 years).","Cost-effectiveness analysis","Published academic journal","Modelled adult population (15-64) with risk status for HIV prevalence and incidence","Intervention - status quo (current testing and treatment levels)","Universal testing = annual HIV testing of all adults.\n\nIt could avert 5% of new infections, even with no behaviour change following HIV diagnosis because of earlier anti-retroviral therapy (ART) initiation, or up to 18% if risky behaviour is halved.","10 years","LA","NHS savings, QALY gains for service users","England",0.03,"£ GBP 2012",2014,"Long EF, Mandalia R, Mandalia S, Alister SS, Beck EJ, Brandeau ML. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom. PLOS ONE. 2014;9(4):e95735.","Link to source","-",2017]
["A24","Sexual Health, Reproductive Health and HIV","STI diagnosis and treatment","Chlamydia screening (UNDER REVIEW)","No","-","Cost-effective","-","National Chlamydia Screening Programme is reviewing the evidence. \n\nThe most recent evidence is a European Centre for Disease Control review on the evidence for chlamydia control, which found that provision of chlamydia screening was found to be cost effective in 9 out of 10 studies.  ","Cost-utility analysis","Published academic journal","-","-","Ten studies in high income countries have reported on the cost-effectiveness of chlamydia screening  in comparison with an alternative strategy. Details on individual studies can be found in the referenced source pp. 45-50.\n\nLimitation of evidence: \nOverstated benefits: Conclusions of studies were often based on assumptions about the probability\nand valuation of utilities for complications of chlamydia that favour screening.\n - High estimates of the probability of complications result from extrapolation from clinical studies to asymptomatic women in the community\n- Applying probabilities of the consequences of pelvic inflammatory disease to all women with chlamydia. \n- High estimates of impact on quality of life result from the application of poorly estimated utilities for a prolonged period of time. ","-","LA","QALY gains for service users","Europe","-","-",2014,"Low N, Redmond S, Alexander K, van Bergen J, Ward H, Uüskula A, Andersen B, Götz H, Herrmann B, van den Broek I, Woodhall S. Chlamydia control in Europe: literature review.","Link to source","-",2017]
["A25","Sexual Health, Reproductive Health and HIV","Preventing and reducing harm from drug misuse in adults","Needle exchange","No","$3.48","-","-","This study investigates if increasing investment in needle/syringe exchange programmes would be cost-effective in terms of HIV prevention in the US. The intervention increase of $50 million would prevent 445 infections, saving $173.97 million, resulting in a return of $3.48 for every $1 invested (BCR).","Cost-benefit analysis","Published Academic Journal","People who inject drugs (PWID)","Usual Care","These results assume the worst-case scenario in terms of parameter values. The benefit-cost ratio is described as a return on investment in the original paper.\nNumber of injections per PWID per year = 812.02\nNumber of borrows per PWID per year in the base case = 81.20\nNumber of new syringes used per PWID per year (base case) = 146.16\nNSP Syringe Unit Cost = $0.48 per syringe\nThis model assumes that 5% of sterile NSP syringes provided are unused and 10% of the additional NSP syringes replace non-sterile syringes.\nLifetime HIV treatment costs are $391,223 in 2011 USD.","1 year","-","ROI/BCR","USA","None","$ USD",2014,"Nguyen TQ, Weir BW, Des Jarlais DC, et al. Syringe exchange in the United States:\na national level economic evaluation of hypothetical increases in investment. AIDS\nBehav 2014;18:2144–55.","Link to Source","-",2019]
["B1","NHS Health Check Programme","NHS Health Check Programme","NHS health check","No","-",2142,"-","The NHS Health Check is a health check-up for adults in England aged 40-74. It's designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia.\n\nCost per QALY of NHS health check programme is £2,142.","Cost-utility analysis","Primary modelling based on published Impact Assessment","-","No intervention","Costs taken from DH Impact Assessment.\n\n15 year average costs are £351m (PCT average £2.31m). Approximately 119,000 QALY gains per year (PCT average 783), through 1,800 strokes prevented, 1500 heart attacks prevented, 9,700 cases of diabetes prevented, 19,000 cases of diabetes /and 24,000 cases of chronic kidney disease (CKD) detected early.\n\n\nCosts savings that arise over the long-term (from prevented strokes, diabetes, CKD, heart attack) are not included in cost per QALY figure.\n\nOver time, costs level off while savings increase. It is estimated that around 70% of costs are recouped  by year 15 (based on PCT level analysis). 15 year average savings are £1.2m (of which £0.8 million due to prevented diabetes, £0.2m due to averted CKD, £0.1m averted strokes).","15 years","LA","QALY gains for service users","England","-","£ GBP 2007",2011,"Kerr, M. (2011). \"NHS Health Check costs, benefits and savings \". Retrieved 22/05/2017","Link to source","-",2017]
["B2","NHS Health Check Programme","NHS Health Check Programme","NHS health check","No","-",2426,"Cost-saving","The NHS Health Check is a health check-up for adults in England aged 40-74. It's designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia.\n\nOffering health checks to all (every 5 years). Results shown for United Kingdom. Other scenarios:\n(1) £887 / QALY\n(2) Cost saving\n(3)  Cost saving\n(4) £48 / QALY\n(5) £1,577 / QALY\n(6) £6,684 / QALY","Cost-utility analysis","Published academic journal","Simulation, based on population aged 40–75.","No intervention","Simulation model generates populations of individuals aged 40–75 eligible for health checks in those countries (e.g. individuals without a previous diagnosis of diabetes, heart attack, stroke, or serious chronic kidney disease). No direct validations have yet been performed.\n\nOther scenarios:\n(1)  Health checks from aged 50, not 40\n(2) Health checks for people with BMI greater than 30kg/m2\n(3) Top quartile of risk, based on non-invasive risk test (based on age / gender / BMI / family history)\n(4) Median quartile of risk,  based on non-invasive risk test (based on age / gender / BMI / family history)\n(5) HbA1c test\n(6) Health check without lifestyle advice / smoking cessation.","30 years","LA","QALY gains for service users, NHS savings","England",0.03,"£ GBP",2013,"Schuetz CA, Alperin P, Guda S, van Herick A, Cariou B, Eddy D, et al. A Standardized Vascular Disease Health Check in Europe: A Cost-Effectiveness Analysis. PLOS ONE. 2013;8(7):e66454.","Link to source","-",2017]
["B3","NHS Health Check Programme","NHS Health Check Programme","NHS health check","No","-",3000,"-","The NHS Health Check is a health check-up for adults in England aged 40-74. It's designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia.\n\nCost per QALY of NHS health check programme is £3,000.","Cost-utility analysis","Impact Assessment","Simulation based on population equivalent to 50 GP lists (90,000 people) aged 40-74.","No intervention","Modelling assumes 75% take-up. Currently it is 50%, with considerable variation between local authorities. Cost / QALY estimated based on conservative assumptions.\n\nCost of programme at full implementation is estimated between £180m and £243m p.a.\n\nAlthough there is some uncertainty in many of the parameters used, sensitivity analysis shows the cost effectiveness of the policy is robust against these uncertainties.\n\nOf all the options considered, the optimal is a starting age of 40 with vascular checks every 5 years.","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"Department of Health. Economic Modelling for Vascular Checks. 2008.","Link to source","-",2017]
["B4","NHS Health Check Programme","NHS Health Check Programme","Statins for primary prevention","No","-",9858,"-","Statin therapy compared with no treatment for the prevention of stroke and coronary heart disease (CHD) in adults who\nhave experienced, or who are at risk of, a coronary event has a cost per QALY of £9,858. The results reported refer to statin therapy for lowering CHD\nannual risk from 1.5% to 1.0% and from 2.5% to 2.0%.","Cost-utility analysis","Published report","Individuals aged 45 to 84 years old with\nCHD risk of 1% to 2.5%","No intervention","Costs and outcomes derived from a review of evidence. \nCost (cost of statins and monitoring - liver function tests, cholesterol tests and creatinine kinase tests).: £5,262 (1% to 1.5%); £4,752 (2% to 2.5%);\nOutcomes (reduced probability of CHD and stroke): 0.24 QALYs, £2,584 cost savings (on average, 1% to 1.5% CHD risk)\n0.21 QALYs, £3,198 cost savings (on average, 2% to 2.5% CHD risk). QALYs and cost savings are likely to be achieved in the long-run (5 years or more).\nReference rated the quality of evidence as good. Affordability of programme rated as low (>£1bn).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-",2017]
["B5","NHS Health Check Programme","NHS Health Check Programme","Screening for diabetes and impaired glucose tolerance","No","-","£6,242-£14,150","-","Screening for diabetes and impaired glucose tolerance followed by lifestyle interventions (e.g. exercise, diet): £6,242 / QALY\nScreening for type 2 diabetes: £14,150 / QALY\nScreening for diabetes and impaired glucose tolerance followed by pharmacological interventions (metformin): £7,023 / QALY","Cost-utility analysis","Published academic journal","A hypothetical population, aged 45 at time of screening, with above average risk of diabetes.","No intervention","93% probability of being cost-effective at a willingness-to-pay threshold of £20 000.\n\nScreening for type 2 diabetes and impaired glucose tolerance, with appropriate intervention for those with impaired glucose tolerance, in an above average risk population aged 45, seems to be cost effective. The cost effectiveness of a policy of screening for diabetes alone, which offered no intervention to those with impaired glucose tolerance, is still uncertain.","50 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"Gillies CL, Lambert PC, Abrams KR, Sutton AJ, Cooper NJ, Hsu RT, et al. Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis. BMJ. 2008;336(7654):1180-5.","Link to source","-",2017]
["B6","NHS Health Check Programme","NHS Health Check Programme","Atrial fibrillation (AF) related stroke","No","-","-","c. £1,453 per person per annum by year 5.","The incidence of avoidable AF-related strokes can be reduced by identifying people at risk who are not anticoagulated / sub optimally anticoagulated.\n\nPHE estimates that the intervention would result in net savings to the system of c£1,453 per person p.a. by year 5. \n","Cost-benefit analysis","PHE primary modelling","-","-","Effectiveness: 1 stroke will be prevented for every 25 patients treated with anticoagulation.\n\nCosts: Cost per intervention, when prescribing anticoagulation, is £648 per patient p.a. in year 1, increasing to £1,000 by year 5. Cost of the anticoagulation per person p.a. ranges from £283 to £800. \n\nNet savings: net savings to the system of c£1,453 per person p.a. by year 5. These can be broken down into c£1,815 p.a. per person savings to the social care system and a cost to the NHS of £362 per person p.a. This cost would contribute towards improved care and quality, and patient safety.","5 years","LA","Social care savings, improved patient quality and experience.","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-",2017]
["B7","NHS Health Check Programme","NHS Health Check Programme","Pharmacist-led interventions to reduce systolic blood pressure","No","-","-","c. £14 per person per annum .","For a 20% improvement in management of hypertension, to 140/90 mmHg target, system net savings would be estimated to be c£14 p.a. per controlled patient over a 5 year horizon. Of these, c£5.75 would accrue to the NHS and c£7.91 would accrue to local authorities.","-","PHE primary modelling","-","-","Costs: c£28 per new controlled person in year 1 (average cost of one 10 minute and three 5 minute consultations with a pharmacist at £64 hourly unit) based on the assumption that achieving a blood pressure treatment to target for one patient will require four consultations with a practice-based pharmacist. \n\nEffectiveness: Pharmacist-led interventions have been shown to reduce systolic blood pressure by an estimated 7.6 mmHg. In the Dudley pilot, 90% of GP practices achieved optimal treatment targets of 140/90mmHg for their hypertensive population (the standard is 50%, and inter-practice variation 6-99%). ","5 years","LA","NHS and LA savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-",2017]
["B8","NHS Health Check Programme","NHS Health Check Programme","Multi-component small scale diabetes prevention","No","-",562,"-","The cost per QALY of multi-component small scale diabetes prevention is £562.","Cost-utility analysis","Published report","Representative sample of the England and Wales population using over 15,000 individuals","-","£179 cost of intervention, with 0.1380 QALY gains over lifetime (discounted). Compared to control.\n\nBased on -1.29 in BMI compared to control.\n\nIntervention remains cost effective with sensitivity analysis on additional NHS follow up (e.g. £886 / QALY, with 6 nurse visits)","Lifetime","LA","QALY gains for service users","England","3.5%; 1.5%","£ GBP",2010,"Gillett M BA, Blake L, Payne N, Goyder L, et al. . Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)",2017]
["B9","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-",9257,"-","Targeted case finding for cardiovascular disease (CVD) prevention.\n\nThe optimum strategy is to rank patients by prior risk estimate and invite 8% of those who are assessed as being at highest CVD risk (those at ≥12.76% predicted 10-year CVD risk). (£9,257 / QALY). ","Cost-utility analysis","Published academic journal","A cohort of 10000 individuals aged 30–74 years","No intervention","£9,257: 17.53 QALYs at a total cost of £162,280 (compared to no case finding).\n\nTargeted approaches through CVD risk dominated those targeting through age alone (i.e. offering checks to those over a certain age is not the most cost effective approach).\n\nFor optimum strategy, over 90% of health gains were in 35% of population at highest risk.\n\nThe paper notes that the most efficient prioritisation makes use of multiple risk factors but the incremental benefits of case finding across the entire population are small in relation to the incremental costs.","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2016,"Crossan C, Lord J, Ryan R, Nherera L, Marshall T. Cost effectiveness of case-finding strategies for primary prevention of cardiovascular disease: a modelling study. British Journal of General Practice. 2017;67(654):e67-e77.","Link to source","-",2017]
["B10","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-","$14,400-$29,300","-","ODPP is an online adaptation of the diabetes prevention program. A weight loss intervention comprising 16 weekly and 8 monthly lessons, incorporating behavioural tools and regular, brief, web-based individualized counselling in an overweight/obese cohort.\n\nODPP delivered in the primary care setting compared with usual care cost approximately $14,400 or $29,300 per QALY gained, respectively, from health care system and societal perspectives (include direct non-medical costs, such as cost of participant time).","Cost-utility analysis","Published academic journal","-","Intervention - usual care","\n\n In probabilistic sensitivity analyses,\nODPP was cost-effective in 20–58% of model iterations using an acceptability threshold of $20,000.","10 years","LA","QALY gains for service users","USA",0.03,"$ USD",2016,"Smith KJ, Kuo S, Zgibor JC, McTigue KM, Hess R, Bhargava T, et al. Cost effectiveness of an internet-delivered lifestyle intervention in primary care patients with high cardiovascular risk. Preventive Medicine. 2016;87:103-9.","Link to source","-",2017]
["B11","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-","$47,439 per CV event avoided.","Cost-saving","CVD prevention and management to improve vascular health in communities.\n\nAt one year, the CVDPMI program is economically acceptable for patients at moderate (ICER of $47,439 per CV event avoided) to high risk for CV events. It is very cost ineffective for low risk groups. The program increased life expectancy at an incremental cost saving ($192) to the healthcare system over a ten year period. ","Cost-utility analysis","Published academic journal","1,187 patients included in population cohort","No intervention","CVDPMI -  Comprehensive Vascular Disease Prevention and Management Initiative.\n\nCosts ($250 / patient) only included for year 1 and for 10 year analysis, benefits assumed to continue.\n\nHealth outcomes based on number of CV events avoided (for 1 year analysis) and life expectancy (for 10 year analysis).","1 / 10 years","LA","QALY gains for service users","Canada","None; 5%","$ CAN 2013",2016,"Kamboj L, Oh P, Levine M, Kammila S, Casey W, Harterre D, et al. Cost effectiveness of a systematic guidelines-based approach to the prevention and management of vascular disease in a primary care setting. International Journal of Cardiology. 2016;203:893-9.","Link to source","-",2017]
["B12","NHS Health Check Programme","NHS Health Check Programme","Screening for type 2 diabetes mellitus (T2DM) and pre-diabetes","No","-","Cost-effective","-","Targeted screening is cost-effective\ncompared to universal screening. Efficiency is optimized and costs are minimized when screening for both prediabetes and T2DM.\n\nFor optimal cost-effectiveness, screening for both T2DM and pre-diabetes should be initiated around age 45-50, with repeated testing every 5 years.","Cost-utility analysis","Published academic journal","Systematic review of 29 studies","Various - see assumptions","Inclusion criteria: Studies between 2000 and 2015, that reported costs and outcomes of screening (universal, targeted, opportunistic) were included.\n\nScreening was compared to no screening in 12 studies (41%), in which screening was found cost-effective in 8 (67%), not cost-effective in 4 (33%) and neither in 1 (8%). \nIn studies comparing different screening methods, 6 found that targeted screening was cost-effective compared with universal screening (none found the opposite), and 1 found opportunistic screening superior to universal. Sensitivity analyses generally confirmed primary findings. Costs were lower when both T2DM and prediabetes were screened compared with T2DM only. Major cost drivers included prevalence of T2DM/pre-diabetes, type of blood test used and rate of uptake of testing.","-","LA","-","-","-","-",2016,"Einarson TR, Bereza BG, Acs A, Jensen R. COST EFFECTIVENESS OF SCREENING FOR TYPE 2 DIABETES MELLITUS AND PRE-DIABETES: SYSTEMATIC LITERATURE REVIEW. Value in Health. 2016;19(3):A302.","Link to source","-",2017]
["B13","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-","Not cost-effective","-","Systematic versus opportunistic risk assessment for the primary prevention of cardiovascular disease.\n\nLimited data suggest that screening has no effect on deaths (from any cause) or the number of people having a stroke or developing coronary heart disease. ","Cost-utility analysis","Published academic journal","Systematic review of 8 studies","Various - see assumptions","Inclusion criteria: RCTs which looked at the effects of systematic risk assessment in healthy adults or those at high risk of developing CVD.\n\nData were also limited for cardiovascular risk factors (blood lipids and blood pressure) where there were some favourable effects with systematic risk assessment, but there were differences between studies and so results are not certain.\n\nThe evidence was generally of low or very low quality. Included studies were at some risk of bias, with four studies judged at high risk of bias. Bearing this in mind, the results of this review need to be interpreted cautiously.","-","-","-","-","-","-",2016,"Dyakova M, Shantikumar S, Colquitt JL, Drew CM, Sime M, MacIver J, et al. Systematic versus opportunistic risk assessment for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews. 2016(1).","Link to source","-",2017]
["B14","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-","Cost-effective","-","Lipid monitoring. Annual testing to monitor blood lipids (fat and cholesterol) was both effective and saved money long term in by reducing cardiovascular disease in people with or without known heart disease. This applied to primary prevention in people with 10%, 15% or 20% risk of cardiovascular disease (CVD) over ten years according to the Qrisk score and those already with heart disease. ","-","-","Patient level data from the UK and Japan","-","This modelling study’s findings are broadly in line with guidance.\nThis modelling study incorporated data from two systematic reviews and patient level data from the UK and Japan to reach its predictions.\n\nA range of lipid blood measures showed similar ability to predict risk of cardiovascular events. For all the different lipid tests, “noise” or biological variation and measurement error make up 25% of the variation in measurements on people who are not already taking statins or using lifestyle measures to reduce their lipid levels. This means that many observed changes in repeat rest results are not “true” differences. \n\nGiven the relatively low cost of treating high lipids (typically by using statins) and high cost of CVD to individuals / health services / society,  it was more cost effective to over-treat people than to under-treat them.","-","-","-","-","-","-",2016,"Perera R ME, McLellan J, Lung T, Clarke P, Perez T, et al. Optimal strategies for monitoring lipid levels in patients at risk or with cardiovascular disease: best marker for monitoring and cost-effectiveness of different monitoring frequencies. Health Technol Assess. 2015;19(100).","Link to source","-",2017]
["B15","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-","$32,476-$32,900","Dominant","Novel risk markers for screening asymptomatic individuals to prevent cardiovascular disease (CVD).\n\nIn the intention-to-treat analysis in men, screening with CT calcium was cost effective ($32,900/QALY) compared with current practice. In women, screening with hsCRP was cost effective ($32,467/QALY). In the as-treated analysis, statin therapy was both more effective and less costly than all other strategies for both men and women.","Cost-utility analysis","Published academic journal","A microsimulation model evaluating lifelong cost-effectiveness for individuals aged 40–85 at intermediate risk of CVD (n=3736)","See assumptions","CT calcium = coronary artery calcification on CT\nhsCRP = High sensitivity CRP\n\nNovel Risk Markers:\n1) High sensitivity CRP (hsCRP), via blood test.\n2) Coronary artery calcification on CT (CT calcium)\n3) Carotid artery intima media thickness on ultrasound (cIMT) \n4) Ankle-brachial index (ABI) \n\nBase Cases:\nIntention-to-treat analysis = base case treatment adherence of 70% and a disutility of 6 months for taking daily medication for the remainder of an individual's lifetime.\nAs-treated analysis = 100% adherence and no disutility.","Lifetime","LA","QALY gains for service users","USA",0.03,"$ USD 2014",2016,"van Kempen BJH, Ferket BS, Steyerberg EW, Max W, Myriam Hunink MG, Fleischmann KE. Comparing the cost-effectiveness of four novel risk markers for screening asymptomatic individuals to prevent cardiovascular disease (CVD) in the US population. International Journal of Cardiology. 2016;203:422-31.","Link to source","-",2017]
["B16","NHS Health Check Programme","NHS Health Check Programme","Intensive treatment for individuals with Type 2 diabetes.","No","-","Not cost-effective","-","Early intensive treatment in people with screen-detected diabetes.\n\nGiven conventional thresholds of cost-effectiveness, the intensive treatment delivered in ADDITION was not cost-effective compared with routine care for individuals with screen-detected diabetes in the UK. The intervention may be cost-effective if it can be delivered at reduced cost.","Cost-utility analysis","Published academic journal","A cluster-randomized controlled trial of early intensive treatment in people with screen-detected diabetes in 69 UK general practices. ","Intervention - routine care.","The intervention was not cost-effective although the ratio improved over time: the ICER over 10 years was £82 250, falling to £37 500 over 30 years. The ICER fell below £30 000 only when the intervention cost was below £631 per patient: the study estimated the cost at £981.","1 / 5/ 10 / 30 years","LA","QALY gains for service users","UK",3.5000000000000003E-2,"£ GBP 2009/10",2016,"Tao L, Wilson ECF, Wareham NJ, Sandbæk A, Rutten GEHM, Lauritzen T, et al. Cost-effectiveness of intensive multifactorial treatment compared with routine care for individuals with screen-detected Type 2 diabetes: analysis of the ADDITION-UK cluster-randomized controlled trial. Diabetic Medicine. 2015;32(7):907-19.","Link to source","-",2017]
["B17","NHS Health Check Programme","NHS Health Check Programme","Screening for Type 2 diabetes","No","-","-","Cost-saving","Screening using a HbA1c test is more cost-effective than using a FPG test for screening Type 2 diabetes.\n\n HbA1c leads to a cost saving of £12 and a QALY gain of 0.0220 per person when a risk score is used as a pre-screen. With no pre-screen, the cost saving is £30 with a QALY gain of 0.0224.","Cost-utility analysis","Published academic journal","England; population in the 40–74-years age range eligible for a NHS health check.","Intervention - FPG test","FPG is a slightly cheaper test, but does not require an 8-hour overnight fast beforehand.\n\nFPG = fasting plasma glucose test\nHbA1c =  a glycated haemoglobin test","Lifetime","LA","QALY gains for service users, NHS savings","England",1.4999999999999999E-2,"-",2015,"Gillett M BA, Watson P, Khunti K, Davies M, Mostafa S, et al. . The cost-effectiveness of testing strategies for type 2 diabetes: a modelling study. Health Technol Assess. 2015;19(33).","Link to source","-",2017]
["B18","NHS Health Check Programme","NHS Health Check Programme","Pre-screening to prioritise screening for Type 2 diabetes.","No","-","Cost-effective","-","Using a risk score such as the Leicester Practice Database Score (LPDS) for pre-screening to prioritise screening for Type 2 diabetes appears to be more cost-effective than using a random capillary glucose (RCG) test to identify individuals with the highest risk of diabetes who should undergo blood testing.","Cost-utility analysis","Published academic journal","England; population in the 40–74-years age range eligible for a NHS health check.","Intervention - RCG test","A risk score may have additional effects not captured within the modelling – the calculation of the score may draw attention to high-risk factors for developing diabetes in the future (rather than just providing a normal/abnormal blood test result). This might prompt individuals to make\nlifestyle changes to reduce their risk.","Lifetime","LA","QALY gains for service users","England",1.4999999999999999E-2,"-",2015,"Gillett M BA, Watson P, Khunti K, Davies M, Mostafa S, et al. . The cost-effectiveness of testing strategies for type 2 diabetes: a modelling study. Health Technol Assess. 2015;19(33).","Link to source","-",2017]
["B19","NHS Health Check Programme","NHS Health Check Programme","NHS Diabetes Prevention Programme","No","-",null,"Cost-saving","Diabetes Prevention Programme (NHS DPP) will identify those at high risk and refer them onto a behaviour change programme. \n\nThis tool simulates what will happen in your local area if the NHS DPP is implemented for one year. Your local population is simulated based on demographic characteristics; age, sex, ethnicity, deprivation and diabetes prevalence. The population is then simulated for 20 years after the NHS DPP to estimate the effects on their health, changes in healthcare costs and to calculate the return on investment.\n\n\n\nNHS DPP becomes cost-effective (based on NICE threshold of £20k / QALY) in year 5 and recoups intervention costs in year 9. Based on the default inputs of the tool, the net monetary benefit of DPP will be £3.26m and has a cost per QALY of £13,971.","ROI tool","ROI tool","England","Intervention - usual care","Evidence based on default inputs for ROI tool and n=1,500:\nIntervention uptake: 32%\nCost: £270\nIntervention effect: default\nEffectiveness: based on meta-analysis commissioned by PHE.\n-Weight loss: 3.24kg\n- BMI reduction: 1.47kg/m2\n- HbA1c reduction: 0.2%\n- Systolic blood pressure reduction: 6.57 mmHg\n - Cholesterol reduction: 0.28 mmol/l\nTime to return to baseline after intervention effect: 5 years","20 years","NHS England","QALY gains for service users, NHS / social care savings","England","3.5.% costs\n 1.5% QALYs","£ GBP",2016,"University of Sheffield. NHS Diabetes Prevention Programme Return on Investment Tool V1.0. 2016.","Link to source","PHE meta-analysis",2017]
["B20","NHS Health Check Programme","NHS Health Check Programme","Statins—disadvantaged groups: culturally sensitive screening","No","-",4260,"-","Identifying and supporting people most at risk of dying prematurely.\n\nThe cost per QALY is estimated at £4,260.","Cost-utility analysis","Published NICE guidance","-","No intervention","2001 non-UK study. £52 pp., cost / QALY = £4,260 (find = £660; treat = £3,600)","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).",2017]
["B21","NHS Health Check Programme","NHS Health Check Programme","Statins—disadvantaged groups: invitation for screening by GP","No","-",4346,"-","Identifying and supporting people most at risk of dying prematurely.\n\nThe cost per QALY is estimated at £4,346. based on 2 estimates ranging from £4,000-£4,692.","Cost-utility analysis","Published NICE guidance","-","Usual care or no intervention","(1) 1996 non-UK study. Cost = £59 pp., cost / QALY= £4,692 (find = £1,092; treat = £3,600)\n(2) 1999 UK study. Cost = £24 pp., cost / QALY = £4,000 (find  = £3,100; treat = £900)","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).",2017]
["B22","NHS Health Check Programme","NHS Health Check Programme","Statins—general population: pharmacist based","No","-",4892,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £4,892,  based on 4 estimates ranging from £1,648–£8,234.","Cost-utility analysis","Published NICE guidance","-","Usual care or no intervention","(1) 2003 non-UK study. Cost = £56.72, cost / QALY = £8,234 (find = £4,634; treat = £3,600)\n(2) 2001 non-UK study. Cost = £6.78; cost / QALY = £7,805 (find = £4,205; treat = £3,600)\n(3) 2000 non-UK study. Cost = £95 pp., cost / QALY =£1,079 (find = £1,079; treat = £900)\n(4) 2006 non-UK study. Cost = £22 pp., cost / QALY =£1,648 (find = £748; treat = £900)","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).",2017]
["B23","NHS Health Check Programme","NHS Health Check Programme","CVD","No","-",21000,"-","A study which aims to quantify the cost-effectiveness and equity impact of the NHS health programme in Liverpool\n\nA stochastic microsimulation model was used to counterfactually simulate individual life courses across five scenarios. A simulation horizon to 2040 was used with the results displayed for those aged between 30 to 84.","Cost-utility analysis","Modelling","Individuals aged between 30 to 84 in Liverpool","No intervention (no NHS Health check programme)","(1) Costs were based on the payment that Liverpool City Council makes to GPs to provide the NHS Health Check programme","23 years","LA","QALY gains for intervention users","England",3.5000000000000003E-2,"£ GBP",2018,"Chris Kypridemos et al 2018 - Future cost-effectiveness and equity of the\nNHS Health Check cardiovascular disease\nprevention programme: Microsimulation\nmodelling using data from Liverpool, UK","Link to source","Further information on the article, authors and metrics",2019]
["B24","NHS Health Check Programme","NHS Health Check Programme","Home blood pressure monitoring for hypertension diagnosis and treatment","No","ROI  $7.50-$19.34 : $1","-","-","A decision-analytic model was used to identify the short and long-run ROI of Clinic BP Monitoring compared to Home BP Monitoring. The ROI varied depending on age group and time-horizon. Over a time-horizon of 10 years, the ROI was $7.50 for individuals between 45-64 years of age and $19.34 for those aged 65 and over. ","Cost–Benefit Analysis (from insurer's perspective)","CBA model using primary data","Members of 2 health insurance plans: 1 private with 25,478 members and 1 Medicare Advantage with 8,253 members, during 2008 to 2011. The plans had a male-to-female ratio of 0.531:1 and 0.592:1, respectively.","Clinic Blood Pressure Monitoring (CBPM)","The cost assumptions are from the perspective of a private health insurer as payer, this includes only the reimbursement cost of Home Blood Pressure Monitoring (HBPM) devices plus the cost of a campaign to raise awareness amongst plan members about reimbursement. Only upper arm BPM were considered, and the equipment lifetime was assumed to be five years. No difference in adherence to hypertensive treatment was assumed.\nROI was calculated as: (savings – cost)/cost","10 years","-","Benefit-Cost Ratio\nShort and Long Run Return on Investment","USA",0.03,"$ USD",2014,"Arrieta A, Woods JR, Qiao N, et al. Cost-benefit analysis of home blood pressure\nmonitoring in hypertension diagnosis and treatment: an insurer perspective.\nHypertension 2014;64:891–6.","Link to source","-",2019]
["B25","NHS Health Check Programme","NHS Health Check Programme","Wellness and disease prevention programme","No","$2.02:1","-","-","The health and wellness programme aims to prevent disease and promote heath by conducting health risk assessments and measuring metabolic risk factors including: blood pressure, total cholesterol, glucose, in addition to body composition measures: such as height, weight, body mass index (BMI), waist circumference, percentage body fat. The participants also received counselling with a healthcare professional to discuss the metrics and develop a plan involving goals and behavioural changes. Investing $1 in the programme produces an average BCR of 2.02 across 8 years (2002-2009), with a minimum of 1.16 in 2003 and maximum of 2.83 in 2002.  ","Cost-benefit analysis","Published Academic Journal","57,940 members of an independent health plan.","No Intervention","The BCR is described as an ROI in the original study.\nNet savings = Healthcare costs for nonparticipant cohort - (Healthcare Costs + Programme Costs for participants)\nIn 2009, the calculations are as follows: \nNet savings = $3,422 - ($2,870 + $288) = $264\nBenefits = Non-participant Healthcare Costs - Participant Healthcare costs = $552\nCost of Programme per Participant = $288\nBCR = $552/$288 = 1.92","8 years","-","Benefit-Cost Ratio\nNet Savings\nHealthcare Costs","USA","Not Stated","Unadjusted $ USD",2014,"Schwartz SM, Mason ST, Wang C, et al. Sustained economic value of a wellness\nand disease prevention program: an 8-year longitudinal evaluation. Popul Health\nManag 2014;17:90–9.","Link to source","-",2019]
["C1","Health Protection","Health Protection","Antimicrobial stewardship (AMS)","No","-","$2,367","-","Antimicrobial stewardship (AMS) team are multidisciplinary healthcare teams formed to optimize anti-infective therapy and to combat antimicrobial resistance and medication errors through improper utilisation of antimicrobials.\n\nAMS teams cost $2367 per QALY gained with a 90% likelihood of cost-effectiveness at a threshold of $10,000 per QALY (and with an even higher probability of cost-effectiveness, and a net monetary benefit of approximately £18,000, using the NHS threshold). ","Cost-utility analysis","Published academic journal","Decision analytical model comparing patients receiving standard treatment with or without AST consult.","Intervention - standard treatment (no AST).","Implementing an AST for bacteraemia review cost $39,737 (95% CI $27,272–$53,017) and standard treatment cost $39,563 (95% CI $27 164–52 797). \n\nAST  produced an additional 0.08 QALYs (as expert opinion on infectious diseases may shift patients from a category of receiving no treatment for significant BSIs  into a category of active treatment for their infection.","-","-","QALY gains for service users","USA","None","$ USD",2009,"Scheetz MH, Bolon MK, Postelnick M, Noskin GA, Lee TA. Cost-effectiveness analysis of an antimicrobial stewardship team on bloodstream infections: a probabilistic analysis. Journal of Antimicrobial Chemotherapy. 2009;63(4):816-25.","Link to source","Evidence included in Menu of Interventions","2017"]
["C2","Health Protection","Health Protection","Antimicrobial stewardship (AMS) ","No","-","-","$261,630 over 2 years.","Antimicrobial stewardship (AMS) team are multidisciplinary healthcare teams formed to optimize anti-infective therapy and to combat antimicrobial resistance and medication errors through improper utilisation of antimicrobials.\n\nDecreased antimicrobial costs of $261,630 were observed over a two-year period after implementation of an ASP that incorporated pharmacy students as integral members of the program in a long-term acute care hospital.","Cost analysis","Published academic journal","Discharge disposition data (n=311, baseline period; n=767 intervention period)","Intervention - AMS without pharmacy students.","The rate of patient discharge to\nskilled nursing facilities was significantly higher during the intervention period (June 10-May 12)\nversus the baseline period (June 09-May 10). \n\nThe mean ± S.D. antimicrobial costs per patient day were $75.37 ± $11.85 in the baseline period and $64.13 ± $13.78 (15% reduction) in the intervention period.","2 years","-","Healthcare savings","USA","None","$ USD",2014,"Benson JM. Incorporating pharmacy student activities into an antimicrobial stewardship program in a long-term acute care hospital. American Journal of Health-System Pharmacy. 2014;71(3):227-30.","Link to source","Evidence included in Menu of Interventions","2017"]
["C3","Health Protection","Health Protection","Antimicrobial stewardship (AMS)","No","-","Cost effective","-","Antimicrobial stewardship (AMS) team are multidisciplinary healthcare teams formed to optimize anti-infective therapy and to combat antimicrobial resistance and medication errors through improper utilisation of antimicrobials.\n\nThe AMS program, using an antimicrobial monitoring team, was extremely cost effective over this 7-year period.","Cost analysis","Published academic journal","At the time of implementation, there were 28,700 patient admission per year.","Analysis of costs before, during and after 7 year program.","The utilization costs decreased from $44,181 per 1,000 patient-days at baseline prior to the full implementation of the program (FY 2001) to $23,933 (a 45.8% decrease) by the end of the program. \n\nThere was a reduction of approximately $3 million within the first 3 years, much of which was the result of a decrease in the use of antifungal agents in the cancer centre. \n\nAfter the program was discontinued, antimicrobial costs increased from $23,933 to $31,653 per 1,000 patient-days, a 32.3% increase within 2 years that is equivalent to a $2 million increase for the medical centre, mostly in the antibacterial category.","7 years","-","Healthcare savings","USA","None","$ USD",2012,"Standiford HC, Chan S, Tripoli M, Weekes E, Forrest GN. Antimicrobial Stewardship at a Large Tertiary Care Academic Medical Centre: Cost Analysis Before, During, and After a 7-Year Program. Infection Control and Hospital Epidemiology. 2012;33(4):338-45.","Link to source","-","2017"]
["C4","Health Protection","Health Protection","Antimicrobial stewardship (AMS)","No","-","-","Cost minimising","Antimicrobial stewardship (AMS) team are multidisciplinary healthcare teams formed to optimize anti-infective therapy and to combat antimicrobial resistance and medication errors through improper utilisation of antimicrobials.\n\nReview finds studies of AMS programmes to be cost minimising (lower drug costs with no worsening in outcomes in terms of hospital readmissions or mortality).","Cost analysis","Published academic journal","-","-","Outcome achieved through reviewing selection, dosage, route of administration and duration of drugs.","-","-","Healthcare savings","Hong Kong","-","-",2015,"You J. Antimicrobial stewardship programs – cost-minimizing or cost-effective? Expert Opinion on Pharmacotherapy. 2015;16(2):155-7.","Link to source","-","2017"]
["C5","Health Protection","Health Protection","Hepatitis B vaccination","No","-","$164-$3,730","-","Routine vaccination of infants in successive birth cohorts to prevent HBV transmission is cost-effective over a wide range of assumptions. While economically less attractive than infant vaccination, adolescent vaccination could serve to protect those children who were not vaccinated as infants.\n\nEstimated in the USA that this would cost US$ 164 per life-year saved for perinatal immunisation (societal perspective). $1,522 for infant vaccination, and $3,730 for adolescent vaccination.","Cost-effectiveness analysis","Published academic journal","-","No intervention","Benefits measured as reductions in healthcare costs  and worklessness costs from  liver disease via hepatitis B virus. Cost-effectiveness calculations excluded QALYs.\n\nFor perinatal infection prevention:\nCosts: $12.6m \nBenefits: $44.8m (worklessness) and $9.3m (healthcare savings)\nNet benefit: $12.6m","-","LA","Healthcare savings, productivity","USA",0.05,"$ USD 1993",1995,"Margolis HS, Coleman PJ, Brown RE, Mast EE, Sheingold SH, Arevalo JA. Prevention of hepatitis b virus transmission by immunization: An economic analysis of current recommendations. JAMA. 1995;274(15):1201-8.","Link to source","-","2017"]
["C6","Health Protection","Health Protection","Flu vaccine","No","£12: £1","Cost-effective","Cost-saving","Vaccinating healthcare workers against influenza to protect the vulnerable.\n\nIt is estimated that there would be savings of £12 per vaccination when health care workers are vaccinated.","Cost-utility analysis","Published academic journal","Elderly population (65+ years)","No intervention","Primary benefits  measured in mortality / morbidity due to influenza in high risk contacts. Secondary outcomes were also considered (e.g. reduced absenteeism due to vaccination).\n\nCost: £6.59 (vaccine), £0.70 (promotion)\nOutcomes: absenteeism reduced by 3 hours pp.. \n\nAssumes 50% uptake.\n\nIntervention is still considered highly cost-effective (£51-405 / life year gained) if absenteeism effects removed.","-","-","Healthcare savings, improved health outcomes","UK",3.5000000000000003E-2,"£ GBP",2006,"Burls A, Jordan R, Barton P, Olowokure B, Wake B, Albon E, et al. Vaccinating healthcare workers against influenza to protect the vulnerable—Is it a good use of healthcare resources?: A systematic review of the evidence and an economic evaluation. Vaccine. 2006;24(19):4212-21.","Link to source","-","2017"]
["C7","Health Protection","Health Protection","Flu vaccine","No","€1.35:€1","Cost-effective","Cost-saving","It is estimated £1.35 would be returned for every £1 spent on opportunistic flu vaccination (given to a patient already consulting a GP with requiring an additional consultation) for high risk individuals.\n\nDuring a major influenza epidemic season, the strategy has a BCR of 4.29 (costs remain constant, but medical costs averted increase).","Cost-utility analysis","Published academic journal","Elderly population (65+ years)","No intervention","Per 10,000 elderly population:\nCost: €38,984\nOutcomes: medical costs averted €52,745\n177 flu cases, 15 hospitalisations reduced, 10.4 life years gained.\n\nVaccination effectiveness parameters used may overstate its true effectiveness in England and Wales (as only serious cases in elderly population are admitted to hospital which the vaccination may be less effective in reducing these type of cases).","Lifetime","LA","Healthcare savings, QALY gains for service users","UK","6%; 1.5%","€ EUR 2000 ","-","Scuffham PA, West PA. Economic evaluation of strategies for the control and management of influenza in Europe. Vaccine. 2002;20(19–20):2562-78.","Link to source","-","2017"]
["C8","Health Protection","Health Protection","Latent tuberculosis infection  (LTBI) therapy","No","-","Cost-effective","-","The current practice (LTBI treatment for TB contacts with a tuberculin skin test (TST) size > or = 5 mm) is cost-effective. A customised approach based on excluding low risk groups from screening and providing treatment to high risk contacts without screening could improve the performance of the program, by reducing healthcare costs from TST tests with a minimal increase in active TB cases.","Cost-effectiveness analysis","Published academic journal","Markov simulation model (n=3,500)","No intervention","Under current policy, 3,500 contacts annually screened. The optimal policy described results in 2,240 less TST tests with only 0.6 extra cases of active TB cases, with a reduction of $60,000 in annual healthcare costs.","6 years","LA","Healthcare savings","Canada",0.03,"$ CAN",2008,"Tan MC, Marra CA, Sadatsafavi M, Marra F, Morán-Mendoza O, Moadebi S, et al. Cost-Effectiveness of LTBI Treatment for TB Contacts in British Columbia. Value in Health. 2008;11(5):842-52.","Link to source","-","2017"]
["C9","Health Protection","Health Protection","Latent TB screening for immigrants","No","-","-","$815 per case","Close-contact investigation (screening close contacts of any person with TB) resulted in net savings of $815 for each prevalent active case detected and treated and $2,186 for each future case prevented.","-","Published academic journal","-","Intervention (passive detection - diagnosing those who seek care with TB symptoms)","Discount rate only applies to  expected number of TB cases. ","1 year","LA","Healthcare savings","Canada",0.03,"$ CAN",2000,"DASGUPTA K, SCHWARTZMAN K, MARCHAND R, TENNENBAUM TN, BRASSARD P, MENZIES D. Comparison of Cost-Effectiveness of Tuberculosis Screening of Close Contacts and Foreign-Born Populations. American Journal of Respiratory and Critical Care Medicine. 2000;162(6):2079-86.","Link to source","-","2017"]
["C10","Health Protection","Health Protection","Latent TB screening for immigrants","No","-","£17,956-£20,819 per prevented case of tuberculosis","-","Screening for latent infection can be implemented cost-effectively at a level of incidence that identifies most immigrants with latent tuberculosis, thereby preventing substantial numbers of future cases of active tuberculosis.\n\nThe two most cost-effective strategies were to screen individuals from countries with a tuberculosis incidence of more than 250 cases per 100,000 (ICER was £17,956  per prevented case of tuberculosis) and at more than 150 cases per 100,000, which identified 92% of infected immigrants and prevented an additional 29 cases at an ICER of £20,819 per prevented case.","Cost-effectiveness analysis","Published academic journal","Decision analysis model based on test results in three UK centres (n=2,211)","Intervention  - see assumptions","Baseline: In line with NICE guidance. Recommends that local tuberculosis services should screen specific subgroups of new entrants for latent infection, including children aged less than 16 years from countries with a tuberculosis incidence or more than 40 per 100 000 per year, and 16–35-year-olds from either sub-Saharan countries or from those with a disease incidence of more than 500 per 100 000 per year. Individuals older than 35 years are not screened because the risks of chemoprophylaxis outweigh the potential benefits.\n\nNational policy thus far would fail to detect 71% of individuals with latent infection. ","20 years","LA","Prevention and reduced transmission of disease","UK","-","£ GBP",2011,"Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ, et al. Screening of immigrants in the UK for imported latent tuberculosis: a multicentre cohort study and cost-effectiveness analysis. The Lancet Infectious Diseases. 2011;11(6):435-44.","Link to source","-","2017"]
["C11","Health Protection","Health Protection","Urinary tract infections (UTIs)","No","-","-","£450 per 100 hospitalised patients","Bladder scanners to reduce catheter associated urinary tract infections (UTIs).\nConservatively assuming a cost per case of £1,500 (with estimates up to £20,000), a 75% reduction in GNBSI related to catheter-associated UTI would provide annual savings of almost £19m in England (minus implementation costs). Studies have found quality improvement programmes to be cost-saving: saving approximately £450 per 100 hospitalised patients. Decision models have demonstrated that nitrofurantoin is cost-minimising when resistance rates to trimethoprim are over 17% (which is the case in England).","Cost-effectiveness analysis","Primary PHE modelling","-","-","Effectiveness: bladder scanners reduced catheter associated UTI by 75%. Similarly, a quality improvement programme in intensive care units reduced CVC-BSI by 80%, while another for urinary catheters reduced catheter-associated UTI by 75%. Assuming 50% of the 50,000 annual GNBSI are related to urinary tract infections, and 50% of these are catheter associated, a 75% reduction estimate results in 9,375 cases of GNBSI related to catheter-associated UTI prevented per year. \n\nCosts: costs of implementing bladder scanners are £49 per scan. Assuming the equivalent of all GNBSI related to UTI are scanned, this gives costs of £1.4m p.a. nationally. Quality improvement programme costs will vary. ","5 years","LA","QALY benefits for service users, NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["C12","Health Protection","Health Protection","Urinary tract infections (UTIs)","No","-","-","Cost-saving","The introduction of silver‐coated urinary catheters was associated with a significant decline in nosocomial UTI and cost savings over the range of cost estimates. The use of the coated catheter appears to be justified, even when subjected to conservative estimates of cost effectiveness.\n\nThe cost‐savings ranged from $13,469 to $535,452 in 2001 and from $5,811 to $484,070 in 2002, based on the cost estimate range in the literature ($700 to $5,682 per episode of a nosocomial UTI).","Cost-effectiveness analysis","Published academic journal","10 units of the Nebraska Medical Centre (approx. 20% of total patient days)","Intervention - uncoated latex catheter","Costs: cost of most commonly used device during study period and total direct cost for nosocomial UTI complications and secondary bacteraemia. \n\nAdditional cost of silver-coated urinary catheters amounted to $64,281 and $65,307 in 2001 and 2002.\n\nBenefits: Number of UTIs prevented (2,006 across 2001 and 2002). \n\nThe benefits and costs were combined by multiplying the number of prevented UTIs by the cost of nosocomial UTI, then adding the cost of bacteraemia associated with 2% of nosocomial UTIs and subtracting the additional cost of the coated urinary catheter.","2 years","LA","QALY gains for service users, NHS savings","USA","-","$ USD 2002",2016,"Rupp ME, Fitzgerald T, Marion N, Helget V, Puumala S, Anderson JR, et al. Effect of silver-coated urinary catheters: Efficacy, cost-effectiveness, and antimicrobial resistance. American Journal of Infection Control. 2004;32(8):445-50.","Link to source","-","2017"]
["C13","Health Protection","Health Protection","Rotavirus vaccine","No","-","-","Possibly cost-saving","Rotavirus vaccine reduces diarrhoea-associated hospitalisations and results in a reduction in treatment costs. Net savings cannot be quantified as the analysis does not include vaccine costs.","Cost-utility analysis","Published academic journal","Children aged less than 5 years old","No intervention","Outcomes: 65,000 diarrhoea-associated hospitalisations between 2007 and 2009, resulting in a reduction of $278 million in treatment costs (savings do not account for cost of vaccine).\n\nA Japanese study found similar reductions in hospitalisations.","3 years","LA","Healthcare savings, QALY gains for service users","USA","-","$ USD 2009",2011,"Cortes  JE, Curns  AT, Tate  JE, Cortese  MM, Patel  MM, Zhou  F, et al. Rotavirus Vaccine and Health Care Utilization for Diarrhoea in U.S. Children. New England Journal of Medicine. 2011;365(12):1108-17.","Link to source","Link to Japanese study","2017"]
["C14","Health Protection","Health Protection","Pneumococcal vaccination","No","-","Cost-effective","Cost-saving","Pneumococcal vaccination with Synflorix in comparison with Prevenar13 is a dominant strategy (a higher number of QALYs and a substantial cost offset) in terms of cost-effectiveness.\n\nCost savings are estimated at €22 million.","Cost-utility analysis","Published academic journal","Children aged less than 2 years old in Spain","Intervention - Prevenar13","Cost: €38.36 (Synflorix) €49.91 (Prevenar13) per dose + €4.88 administration per person.\n\nOutcomes: €22 million in savings, 143 QALYs gained, 41,513 episodes of acute otitis media (ear inflammation),  382 myringotomy procedures (treatment for ear inflammation) and 36,324 antibiotic prescriptions prevented.","1 year","LA","Healthcare savings, QALY gains for service users","Spain","None","€ EUR 2010",2011,"Morano R, Pérez F, Brosa M, Pérez Escolano I. Cost-effectiveness analysis of pneumococcal vaccination in Spain. Gaceta Sanitaria. 2011 Aug;25(4):267-73.","Link to source","English translation of abstract","2017"]
["C15","Health Protection","Health Protection","Active Tuberculosis","No","-","£6,400-£10,000","-","The Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis in London.\n\nThe incremental cost effectiveness of the Find and Treat service is estimated to be £6,400-£10,000 / QALY gained. Both the mobile screening unit (£18,000-£26,000 / QALY) and the case management component (£4,100-£6,800 / QALY) of the service seem to be cost effective, even in unfavourable (and highly unlikely) scenarios.","Cost-utility analysis","Published academic journal","Cohort model of hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service","No intervention","Cost: Net cost of £1.4m / year (£1m = Find and Treat Service; £400k = treatment costs).\n\nOutcomes: On average, the service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. Under conservation assumptions, the service gains 220 QALYs (approx. 30 QALYs from screening; 190 from referrals).","3 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP 2009/10",2011,"Jit M, Stagg HR, Aldridge RW, White PJ, Abubakar I. Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation. BMJ : British Medical Journal. 2011;343.","Link to source","-","2017"]
["C16","Health Protection","Health Protection"," Meticillin resistant Staphylococcus aureus (MRSA)","No","-","See summary","-","Screening, isolation, and decolonisation strategies in the control of meticillin resistant Staphylococcus aureus (MRSA) in intensive care units.\n\nFor a willingness to pay of up to about £17,000 per QALY the approach to do nothing was favoured. Within the usual NHS willingness to pay range of £20,000 to £30,000, the best strategy was to isolate only those patients at high risk of carrying MRSA.","Cost-utility analysis","Published academic journal","Dynamic transmission model for theoretical population of patients on an intensive care unit","No intervention","Costs: Estimated costs included direct costs of the intervention, infection related treatment costs, and extra bed days and their associated opportunity costs\n\nHealth benefits (summarised by QALYs) were reduced morbidity (during an episode on the intensive care unit) and reduced mortality owing to avoided infections.\n\nMRSA control strategies that use decolonisation (eliminate or suppress MRSA using topical antimicrobials) are likely to be cost saving in an intensive care unit setting provided resistance is lacking. All decolonisation strategies improved health outcomes and reduced costs. Universal decolonisation was most cost effective in the short-term, although targeted strategies may be preferred owing to the reduced risk of selecting for resistance.","-","LA","QALY gains for service users, healthcare savings","England","None","£ GBP",2011,"Robotham JV, Graves N, Cookson BD, Barnett AG, Wilson JA, Edgeworth JD, et al. Screening, isolation, and decolonisation strategies in the control of meticillin resistant Staphylococcus aureus in intensive care units: cost effectiveness evaluation. BMJ. 2011;343.","Link to source","-","2017"]
["C17","Health Protection","Health Protection","Human papillomavirus vaccine","No","-","See summary","-","Evidence compares bivalent (stimulates immune response against 2 antigens) and quadrivalent (stimulates immune response against 4 antigens) human papillomavirus (HPV) vaccinations.\n\nThe quadrivalent vaccine seems to be cost-effective under most scenarios (£12,000-£19,000 / QALY); bivalent vaccination is less cost-effective, ranging from £16,000-£25,000 / QALY. Under the most pessimistic scenarios, both vaccination may not be cost-effective at £20k threshold, quadrivalent (£22k) bivalent (£41k).\n\nThe quadrivalent vaccine may have an advantage over the bivalent vaccine in reducing healthcare costs and QALYs lost. The bivalent vaccine may have an advantage in preventing death due to cancer. However, considerable uncertainty remains about the differential benefit of the two vaccines.","Cost-utility analysis","Published academic journal","Transmission model for males and females aged 12–75 years.","No intervention","Costs: vaccination = £84.50 per dose; administration = £28 per dose; screening = £54; treating anogenital warts = £112; per cancer case = £15,000; Recurrent respiratory papillomatoses = £4,900 (adults); £30,000 (child)\n\nQALY loss: cervical cancer diagnosis (0.26-0.33)\n\nThe price difference per dose ranges from a median of £19 (interquartile range £12–£27) to £35 (£27–£44)","100 years","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP 2008/09",2011,"Jit M, Chapman R, Hughes O, Choi YH. Comparing bivalent and quadrivalent human papillomavirus vaccines: economic evaluation based on transmission model. BMJ. 2011;343.","Link to source","-","2017"]
["C18","Health Protection","Health Protection","Rotavirus vaccine","No","-","€40,041-€44,263; €56,656-€57,897","-","Hypothetical scenario presented from 3 models, representing developed countries in the European setting.\n\nThe three models provided a cost per QALY of €40,041-€44,263 (from a societal perspective) and €56,656-€57,897 (from a healthcare perspective).","Cost-utility analysis","Published academic journal","Original source - Table 2","-","For further information on key figures and outcomes on European scenario, see original source (Tables 3-10).\n","LA","-","-","Europe","-","€ EUR",2011,"Postma MJ JM, Rozenbaum MH, Standaert B, Tu H-A, Hutubessy RC. Comparative review of three cost-effectiveness models for rotavirus vaccines in national immunization programs; a generic approach applied to various regions in the world. 2011;9(84).","Link to source","-","2017"]
["C19","Health Protection","Health Protection","Rotavirus vaccine","No","-","€76,000-€110,000","-"," Rotavirus vaccination in England and Wales.\n\nEvidence concludes that the vaccination is not cost-effective and has an ICER of €76,000-€110,000 (lower estimate assumes no waning of vaccine protection).","-","-","-","-","Cost: €27.50-€35 per dose","LA","-","-","England and Wales",0.03,"€ EUR 2006",2009,"Jit M, Mangen M-JJ, Melliez H, Yazdanpanah Y, Bilcke J, Salo H, et al. An update to “The cost-effectiveness of rotavirus vaccination: Comparative analyses for five European countries and transferability in Europe”. Vaccine. 2010;28(47):7457-9.","Link to source","-","2017"]
["C20","Health Protection","Health Protection","Antimicrobial stewardship (AMS) - Large Reduction","No","-","Dominated","-","An antimicrobial stewardship programme that reduces antibiotic use\nacross the hospital such that patients in the vulnerable category are\nreduced from 50% to 25% (best reported reduction attributed to AMS\nprogrammes).\n","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C21","Health Protection","Health Protection","Antimicrobial stewardship (AMS) - Moderate Reduction","No","-","Dominated","-","An antimicrobial stewardship programme that reduces antibiotic use\nacross the hospital such that patients in the vulnerable category are\nreduced from 50% to 40% (average reported reduction attributed to AMS\nprogrammes).","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C22","Health Protection","Health Protection","Hygiene (HYG) - Large Reduction","No","-","Cost-saving","-","A hygiene improvement intervention that has the effect of reducing the\ntransmission rate by half","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C23","Health Protection","Health Protection","Hygiene (HYG) - Moderate Reduction","No","-","Dominated","-","A hygiene improvement intervention that has the effect of reducing the\ntransmission rate by a quarter","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C24","Health Protection","Health Protection","Fecal Microbiota Transplant (FMT) 1 - Moderate Reduction","No","-","Dominated","-","Expedited gut recovery due to FMT for infected patients (time to recovery\nhalved± 45 days)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C25","Health Protection","Health Protection","Fecal Microbiota Transplant (FMT) 2 - Large Reduction","No","-","Dominated","-","Expedited gut recovery due to FMT for infected patients (best reported\nrecovery rate± 10 days)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C26","Health Protection","Health Protection","Fecal Microbiota Transplant (FMT) 3 - Conservative Reduction","No","-","Dominated","-","Expedited gut recovery due to FMT for infected patients (worst reported\nrecovery rate± 62 days)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C27","Health Protection","Health Protection","Antimicrobial stewardship (AMS) & Hygiene - Moderate AMS, Large HYG Reduction","No","-","Dominated","-","An antimicrobial stewardship programme and hygiene improvement\nprogramme delivered as a bundle (reduction in antibiotic use from 50% to\n40% of patients; transmission rate halved due to effectiveness of hygiene\nimprovement programme)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C28","Health Protection","Health Protection","Hygiene & Fecal Microbiota Transplant  (FMT) 1 - Moderate FMT, Large HYG Reduction","No","-","Dominated","-","A hygiene improvement programme delivered in conjunction with FMT\nfor recurrently infected patients (gut recovery time halved due to FMT;\ntransmission rate halved due to effectiveness of hygiene improvement\nprogramme)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C29","Health Protection","Health Protection","Hygiene & Fecal Microbiota Transplant (FMT) 2 - Large FMT, Large HYG Reduction","No","-","Dominated","-","A hygiene improvement programme delivered in conjunction with FMT\nfor recurrent patients (best reported gut recovery rate due to FMT;\ntransmission rate halved due to effectiveness of hygiene improvement\nprogramme)","Cost-effectiveness","Modelling","Adult hospital patients in Australia","No intervention (standard care)","Markov modelling study\nData collected over an 18 month period\nWTP threshold of $42,000/QALY","lifetime","-","Incremental intervention cost\nQALYs\nICER","Australia","Costs and health outcomes both at 5%"," $ AUD 2015 ",2018,"Economic evaluation of interventions designed to reduce Clostridium difficile infection - D.Brian et al 2018","Link to source","-",2019]
["C30","Health Protection","Health Protection","Mandatory screening of all admissions for meticillin-resistant staphylococcus aureus (MRSA)","No","-","-","Mean cost per QALY £89,000 - £148,000","In December, 2010, National Health Service (NHS) England introduced national mandatory screening of all admissions for meticillin-resistant Staphylococcus aureus (MRSA). We aimed to assess the effectiveness and cost-effectiveness of this policy, from a regional or national health-care decision makers' perspective, compared with alternative screening strategies.\n\nOur results show that screening all admissions for MRSA is unlikely to be cost effective in England at the current NHS willingness-to-pay threshold, and our findings informed modified guidance to NHS England in 2014. Screening admissions to high-risk specialties is likely to represent better resource use in terms of cost per QALY gained.","Cost-effectiveness","Modelling ","Patients in English NHS hospitals","No intervention \n(No screening)","£30,000/QALY willingness to pay threshold\nIndividual-based dynamic transmission model \nHealth benefits, summarised by changes in QALYs, are estimated over a patients lifetime.","5 years","NHS","ICER","England","Costs undiscounted\n\nHealth benefits discounted (not disclosed)","£ GBP",2015,"Cost-effectiveness of national mandatory screening of all admissions to English National Health Service hospitals for meticillin-resistant Staphylococcus aureus: a mathematical modelling study - Robotham.J et al 2015","link to source","-",2019]
["C31","Health Protection ","Vaccination","Haemophilus Influenza Type B vaccination","No",1.06,"-","-","Providing vaccinations against Haemophilus Influenza Type B (Hib) provides benefits of $165.2 million at a cost of $155.3 million resulting in a BCR of 1.06","Cost-benefit analysis","Published Report","Children (0-14 years of age)","No Intervention","The benefits of Hib vaccinations are defined as averted cases of Hib, which are allocated to 3 categories of disease (meningitis, epiglottitis and other), death and four disability categories (severe disability, less severe disability, hearing aid and less severe hearing loss).\n Deaths averted are valued at $1 million because they are child deaths. \nA discount rate of 5% was applied. ","15 years","-","Hib cases averted.\nCost of Immunisation.\nBenefits of immunisations.\nBenefit-Cost Ratio","Australia",0.05,"$ AUD",2003,"Abelson P, Taylor R, Butler J, et al. Returns on Investment in Public Health.\nCanberra: Department of Health and Ageing, 2003.","Link to Source","-",2019]
["C32","Health Protection ","Vaccination","Measles vaccination","No",167,"-","-","Providing vaccinations against measles provides benefits of $9,204.3 million to society (including $8.531 billion to government) at a cost of $54.9 million, resulting in a BCR of 167 for each $1 invested.","Cost-benefit analysis","Published Report","Children","No Intervention","The benefits of immunisation are estimated using the number of lives saved, measles disability averted and treatment savings at mid-1990s costs.\nUncomplicated measles costs $2,982, measles encephalitis costs $124,622 over 20 years and subacute schelerosing panencephalitis costs $140,440 over 10 years.\nDeaths averted are valued at $1 million because they are child deaths. \nA discount rate of 5% was applied.","33 years","-","Benefit-Cost Ratio","Australia",0.05,"$ AUD",2003,"Abelson P, Taylor R, Butler J, et al. Returns on Investment in Public Health.\nCanberra: Department of Health and Ageing, 2003.","Link to Source","-",2019]
["C33","Health Protection","Health Protection","Universal Hepatitis B vaccination","No","ROI €2.78: €1","-","-","Providing universal vaccinations to infants and adolescents against Hepatitis B provides benefits of €2.78 for every €1 invested.","Cost-benefit analysis","Published Academic Journal","Universal for infants and adolescents","No Intervention i.e. No Vaccination","The benefits of the Hepatitis B immunisation were measured in terms of health states related to Hep B infection, which were averted. These are: symptomatic acute HBV infection (AHB), chronic hepatitis B (CHB), compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC). \nThe model estimates the number of cases per year of the previous health states, with/without the vaccination programme. The difference is the net cost or benefit.\nA discount rate of 3.0% was applied","20 years","-","Benefit-Cost Ratio\nClinical Savings\nVaccination Costs","Italy",0.03,"€ EUR",2013,"Boccalini S, Taddei C, Ceccherini V, et al. Economic analysis of the first 20 years of\nuniversal hepatitis vaccination program in Italy: an a posteriori evaluation and\nforecast of future benefits. Hum Vaccines Immunother 2013;9:51119–128.","Link to Source","-",2019]
["C34","Health Protection","Health Protection","Influenza vaccination of healthy workers","No","-","-","Net Costs:  -$.27 to +$174.32","Providing vaccinations for influenza to healthy adults results savings of $174.32 in the best-case scenario and a net cost of $21.27 in the worst case scenario.","Cost-benefit analysis","Published Academic Journal","Healthy working adults aged between 18 and 64 years.","No Intervention","Net Costs (Savings) = Costs of Vaccination - Costs Averted Due to Vaccination\nThis study assumed that vaccinations were delivered in a low cost setting such as work place clinics, pharmacies and supermarkets.\nThe model assumes workers are full-time and work all year therefore the results may not apply to part-time or seasonal workers.\nThe best case scenario used a discount rate of 3.0% and the worst-case scenario used a discount rate of 5.0%","1 year","-","Net Costs or Savings","USA",0.03,"1998 $USD",2001,"Nichol KL. Cost-benefit analysis of a strategy to vaccinate healthy working adults\nagainst influenza. Arch Intern Med 2001;161:749.","Link to Source","-",2019]
["C35","Health Protection","Health Protection","Influenza vaccination of healthy workers","No","-","-","Net Costs:  -$.27 to +$174.32","Providing vaccinations for influenza to healthy adults results savings of $174.32 in the best-case scenario and a net cost of $21.27 in the worst case scenario.","Cost-benefit analysis","Published Academic Journal","Healthy working adults aged between 18 and 64 years.","No Intervention","Net Costs (Savings) = Costs of Vaccination - Costs Averted Due to Vaccination\nThis study assumed that vaccinations were delivered in a low cost setting such as work place clinics, pharmacies and supermarkets.\nThe model assumes workers are full-time and work all year therefore the results may not apply to part-time or seasonal workers.\nThe best case scenario used a discount rate of 3.0% and the worst-case scenario used a discount rate of 5.0%","1 year","-","Net Costs or Savings","USA",0.03,"1998 $USD",2001,"Nichol KL. Cost-benefit analysis of a strategy to vaccinate healthy working adults\nagainst influenza. Arch Intern Med 2001;161:749.","Link to Source","-",2019]
["C36","Health Protection","Health Protection","Haemophilus Influenzae Type B vaccination","No",5.4,"-","-","Providing  the conjugate vaccine against Haemophilus Influenza Type B (Hib) provides benefits of $2.58 billion at a cost of 0.48 billion (from a societal perspective) resulting in a BCR of 5.4. From a direct medical perspective, the benefits were $1.35 billion at a cost of 0.39 billion resulting in BCR of 3.4.","Cost Benefit Analysis and Cost Utility Analysis","Published Academic Journal","All Children who are aged 2 months","No Intervention","This model is based on a hypothetical US birth cohort of 3,815,469 infants in 2000. Without vaccination there are 17,589 Hib cases and 665 deaths. With the vaccinations programme, Hib cases are reduced by 99.7% and Hib deaths by 99.6%. The vaccination programme results in 97,878 years of life saved, 27,301 discounted years of life saved, and 113,644 QALYs gained. \nFrom a societal perspective, the Hib programme spends $28,073 to prevent a Hib infection, $743,209 for a Hib-related death, $4,903 to save a life-year, $17,577 to save 1 discounted life-year, and $4,223 to gain 1 QALY.\nFrom a direct perspective, the Hib programme spends $55,598 to prevent a Hib infection, $1,471,888 for a Hib-related death, $9,710 to save a life-year, $34,811 to save 1 discounted life-year, and $8,363 to gain 1 QALY.\nIf the Hib vaccine was administered as a single vaccine, the direct and societal benefit-cost ratios would be 3.2 and 5.0, respectively. If all Hib vaccines were administered in combination vaccines, then the direct and societal benefit-cost ratios would be 4.7 and 7.5, respectively","Lifetime","-","Benefit-Cost Ratio","USA",0.03,"2000 $USD",2002,"Zhou F, Bisgard KM, Yusuf HR, et al. Impact of universal haemophilus influenza\ntype B vaccination starting at 2 months of age in the United States: an economic\nanalysis. Paediatrics 2002;110:653–61.","Link to Source","-",2019]
["F1","Obesity and Physical Activity","Dietary and Nutrition","Broad dietary education/cooking skills","No","-",878,"-","The cost per QALY is estimated at £878.\n\nTwo to three hour group session for 10 weeks. Informal educational session covering food hygiene, nutrition and food tasting and a standardised two hour food skills intervention programme delivered over seven weeks. Delivered by CookWell project worker/facilitator\n(assumed to be health promotion professional).","Cost-utility analysis","Modelling","Low socioeconomic status","No intervention","Sensitivity analysis was not probabilistic and so did not allow for uncertainty despite studies having varying degrees of uncertainty. Interventions were considered for use in deprived populations although further modelling suggested that they would be more cost effective if directed at obese populations.\n\nDirect cost per individual: £82\nOutcomes: 0.0129 average lifetime QALY gain per participant\n","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2010,"Gillett M, Brennan A, Blake L, Payne N, Goyder L, Woods HB, Everson-Hock E, Johnson M, Chilcott J, Hernandez M. Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010 Nov 8:1-69.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)","2017"]
["F2","Obesity and Physical Activity","Dietary and Nutrition","Education to promote increased fruit and vegetable intake","No","-","Not cost-effective","-","Intervention is not cost-effective. Estimated effects on markers of CVD risk and diabetes are not significant enough to result in a reduction in events.","Cost-utility analysis","Published NICE guidance","Low socioeconomic status","No intervention","Sensitivity analysis was not probabilistic and so did not allow for uncertainty despite studies having varying degrees of uncertainty. Interventions were considered for use in deprived populations although further modelling suggested that they would be more cost effective if directed at obese populations.\n\nDirect cost per individual: £46.33\nOutcomes: No lifetime QALY gain per participant","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2010,"Gillett M, Brennan A, Blake L, Payne N, Goyder L, Woods HB, Everson-Hock E, Johnson M, Chilcott J, Hernandez M. Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010 Nov 8:1-69.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)","2017"]
["F3","Obesity and Physical Activity","Dietary and Nutrition","Opening of a new food retail outlet","No","-","Not cost-effective","-","Intervention to improve access to healthy food by opening a new food retail outlet.\n\nIntervention is not cost-effective. Estimated effects on markers of CVD risk and diabetes are not significant enough to result in a reduction in events.","Cost-utility analysis","Published NICE guidance","Low socioeconomic status","No intervention","Sensitivity analysis was not probabilistic and so did not allow for uncertainty despite studies having varying degrees of uncertainty. Interventions were considered for use in deprived populations although further modelling suggested that they would be more cost effective if directed at obese populations.\n\nDirect cost per individual: £0\nOutcomes: No lifetime QALY gain per participant","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2010,"Gillett M, Brennan A, Blake L, Payne N, Goyder L, Woods HB, Everson-Hock E, Johnson M, Chilcott J, Hernandez M. Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010 Nov 8:1-69.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)","2017"]
["F4","Obesity and Physical Activity","Education","School based education","No","-",599,"-","A school-based intervention designed to reduce obesity in youth of middle-school age. The program was an interdisciplinary\ncurriculum for both male and female students. Intervention material was incorporated into four major subject\nareas (language arts, math, science, and social studies) and into physical education. Sessions focused on decreasing\ntelevision viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing\nmoderate and vigorous physical activity. The intervention was effective only among female students.","Cost-utility analysis","Published report","Females 11 to 16 years old ","No intervention - usual curricula","Cost: £24 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\n\nOutcomes: reduces the chances of middles-school\nage students of becoming overweight adult females by 1.87 per cent, which results in 0.013 QALYs per person, £16.20 cost savings per person.  Benefits accrue as a result of reduced probabilities of four diseases associated with physical inactivity - type II diabetes, stroke, coronary heart disease and colon cancer. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["F5","Obesity and Physical Activity","Green Space","Cycling Infrastructure","No","£11:£1","-","-","This modelling approach uses information within the reviewed literature to estimate an average value of the benefit and cost component per kilometre cycled. \n\nAll the reviewed cost-benefit analyses showed that interventions which changed the environment and resulted in increased cycle and walking usage suggests that these are profitable to society.","-","-","-","-","This figure has been derived based on figures reported in the literature, which may be optimistic. Further, the standardised figure is sensitive to changes in the assumption related to the number of new trips per user. Nevertheless, on balance, cautious support could be given to an economic case related to increasing cycling levels in the general population.\n\nBenefits included in this analysis are health benefit, comfort and insecurity, time travel benefit and short-term absenteeism. Capital and maintenance costs have been included in this analysis. ","Lifetime","-","NHS and PSS","-",3.5000000000000003E-2,"£ GBP 2006",2007,"Beale S, Bending M, Trueman P. An economic analysis of environmental interventions that promote physical activity. University of York: York Health Economics Consortium. 2007 May.","Link to source","Based on evidence from evaluations conducted by NICE (PH8)","2017"]
["F6","Obesity and Physical Activity","Green Space","Urban Trails","No","-",10445,"-","The cost per QALY is estimated at £10,445, based on 4 estimates ranging from £2,640-£25,150.","Cost-utility analysis","Modelling","Aged 40-60","No intervention","Reduced likelihood of developing CHD, stroke and Type 2 diabetes (by age group) for the active population based on information on relative risk extracted from the literature.\n\nVariation is due to differences in approaches of the 2 cities, one used existing trails and the other developed new ones on the tracks of disused railways thus altering the costs of the intervention and subsequent cost effectiveness. ","Lifetime","-","NHS and PSS","-",3.5000000000000003E-2,"£ GBP",2007,"Beale S, Bending M, Trueman P. An economic analysis of environmental interventions that promote physical activity. University of York: York Health Economics Consortium. 2007 May.","Link to source","Based on evidence from evaluations conducted by NICE (PH8)","2017"]
["F7","Obesity and Physical Activity","Mass Media","National mass media campaigns","No","-","-",-3290,"A health education campaign undertaken by the BBC: ’Fighting Fit, Fighting Fat’ (FFFF). The campaign spanned over\nseven weeks of numerous peak and day-time programming across BBC One and Two, BBC Radio 2 and local BBC\nradio programmes. FFFF was supported by a website, Ceefax pages, a book, a video, the Radio Times and telephone\nlines for further information. People were invited to register and buy a pack containing a self-help guide for lifestyle\nchange. \n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","-","No intervention","Cost: £73.60 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\n\nOutcomes: 16.9% increase in the chance of becoming physically active, producing 0.736 QALYs per person, £2,494 cost savings per person. Benefits accrue as a result of reduced probabilities of four diseases associated with physical inactivity - type II diabetes, stroke, coronary heart disease and colon cancer. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["F8","Obesity and Physical Activity","Physical Activity","Active travel","No","£1.49-£2.64: £1","£2,900-£9,400","-","The cost per QALY of pedometer interventions (short term) is estimated to be of £2,900 using the continuous risk function, or £9,400 using the step risk function. CBR due to congestion benefits only.","Cost-utility analysis","Published NICE guidance","Age 16+ as represented by 2008 HSE","Intervention - Low physical activity","Assumed zero decay in effect after year 1 because the Baker 2008a study showed a return almost to baseline walking levels at 12 months.\n\n It should be noted that the CBR shown here is for illustration, using the full cost of each intervention applied to only the specific subset of transport-related outcomes, and they should therefore be interpreted only within this context. They are much lower than values that would be obtained from a more comprehensive cost-benefit analysis. This fuller analysis would include health benefits  and other wider economic and societal benefits and losses. ","Lifetime","LA","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2011",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F9","Obesity and Physical Activity","Physical Activity","Active travel","No","-","£750-£7,800","-","For pedometer interventions (long term), for a scenario where the ongoing cost per participant is around £25, the cost per QALY is estimated to be of the order of £1,700 (continuous risk function), or £7,800 (step risk function). With ongoing costs of around £9 per participant, results are estimated at £750 per QALY (continuous risk function), or £3,400 per QALY (step risk function).","Cost-utility analysis","Published NICE guidance","Age 16+ as represented by 2008 HSE","Intervention - Low physical activity","For the longer-term support pedometer intervention, evidence suggests that an effect persists to 12 months. In the scenarios modelled, we assume that this level would be maintained in future years provided the support costs (advice and telephone support) were maintained. The results suggest that longer-term support to pedometers appears cost-effective. \n\nThe evidence from Baker 2008b suggests that an effect persists to 12 months. In the scenarios modelled, it is assume that this level would be maintained in future years provided the support costs (advice and telephone support) are maintained.\n\n","Lifetime","LA","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2011",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F10","Obesity and Physical Activity","Physical Activity","Active travel","No","£5.17: £1",900,"-","For Sustainable Travel Towns (multi-component intervention), the modelled cost-effectiveness is estimated to be of the order of £900 per QALY for models runs using either the percentage change in trips evidence or the walking and cycling distance evidence.","Cost-utility analysis","Published NICE guidance","Age 16+ as represented by 2008 HSE","Intervention - Low physical activity","Results suggest that interventions such as sustainable travel towns could probably be considered more cost-effective than pedometers or led-walking.\n\nEvidence for the effectiveness of the Travel Smart programme come in the form of increases in walking and cycling, decrease in car trips, and increases in sustainable travel trips from a 4 year funded programme to promote sustainable travel in Darlington, Peterborough and Worcester.\n\n It should be noted that the CBR shown here is for illustration, using the full cost of each intervention applied to only the specific subset of transport-related outcomes, and they should therefore be interpreted only within this context. They are much lower than values that would be obtained from a more comprehensive cost-benefit analysis. This fuller analysis would include health benefits  and other wider economic and societal benefits and losses.","Lifetime","LA","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2011",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F11","Obesity and Physical Activity","Physical Activity","Active travel","No","£2.6-£3.5 ",5000,"-","For Cycling Demonstration Towns (multi-component intervention), the modelling undertaken suggests that the intervention appears cost-effective. The cost per QALY is estimated to be of the order of £5,000 for models runs using either the continuous or the step risk function.\n\nWhilst primarily an analysis of infrastructure investment, it was combined with a programme of education and marketing, and was aimed at the general population. Also included was a walking school bus to promote walking to school.\n\nThe evidence on cycle demonstration town is directly applicable as it was conducted\nin the UK.","Cost-utility analysis","Published NICE guidance","Age 18-70","Intervention - Low physical activity","The paper reported an annual 4% increase in the number of cyclists, and an increase in the number of cycle trips of 27% by 2009, compared with the baseline in 2005. The percentage of adults who cycled regularly rose, and those who were classified as inactive fell from 26.2% to 23.6%.\n \nThe CBR range reflects the different approaches available for estimating accident and absenteeism benefits. Under all but the most pessimistic of scenarios considered, the benefit-cost ratio remained above one.\n","Lifetime","LA","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2011",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F12","Obesity and Physical Activity","Physical Activity","Active travel","No","£51.2: £1","£300-£2,500","-","For Travel Smart (personalised travel support), the modelling undertaken suggests that the intervention appears cost-effective. The cost per QALY is estimated to be of the order of £300 using the continuous risk function, or £2,500 using the step risk function.","Cost-utility analysis","Published NICE guidance","Age 16+ as represented by 2008 HSE","Intervention - Low physical activity","Evidence for the effectiveness of the Travel Smart programme come in the form of increases in walking and cycling, decrease in car trips, and increases in sustainable travel trips.\n\nTravel Smart has such a high benefit-cost ratio estimate here because the costs estimated are low. These results appear to suggest that, if only these environmental outcomes were considered, Travel Smart would be the most cost-effective intervention, followed by the Sustainable Travel Towns programme.","Lifetime","LA","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F13","Obesity and Physical Activity","Physical Activity","Active travel","No","-",2700,"-","The 'Get Walking Keep Walking’ intervention was modelled  using evidence from an evaluation of a large UK study. The modelling undertaken suggests that the intervention appears cost-effective. The cost per QALY is estimated to be of the order of £2,700.","Cost-utility analysis","Published NICE guidance","Age 16+ as represented by 2008 HSE","Intervention - Low physical activity","Cost of uptake pp. = £55\nAnnual decay in effectiveness = 40%\nChange in physically active = 22.4%","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F14","Obesity and Physical Activity","Physical Activity","Active travel","No","-","£1,900-£29,436","-","For led walking, the results of the modelling undertaken suggest that the intervention appears cost-effective but is very sensitive to the level of effect assumed. The cost per QALY is estimated to be of the order of £1,900 using 100% of the apparent effect from the trial, £3,600 using 50% of the apparent effect, and £16,500 using 10% of the apparent effect. For this 10% of the apparent effect scenario, but using slightly lower costs obtained from personal communication with representatives of Derbyshire Primary Care Trust, the cost per QALY is estimated to be of the order of £10,400.","Cost-utility analysis","Published NICE guidance","Age 40-70 with low levels of physical activity","Intervention - Low physical activity","\nThe evidence is partially applicable to the UK, with 2 of the studies UK based, and the other international studies concerning interventions that could be of UK relevance.\nThe estimated net benefits for each led walking scenario are generally lower than for the other interventions examined. If one does not believe that 100% of the before and after effect seen in some of the studies would accrue in practice then the estimated net benefits are lower still (e.g. 50% effect £854m, 10% effect £39m). Again, this does not mean that decision makers should ignore led walking as an option within a mix of interventions but, at least from a health economics interpretation, one would probably not want to see it as the single intervention used by decision makers to achieve cost-effective sustained behaviour change in walking and cycling.\n\ncost effectiveness variation is related to both the level of effectiveness modelled (e.g. 10%-100%) and level of effect decay (0-100%)","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2012,"School of Health and Related Research. Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation: Health economic and modelling report. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH41)","2017"]
["F15","Obesity and Physical Activity","Physical Activity","Brief advice on physical activity","No","£9.8: £1 (modelled) ","£1,730-£27,000","-","If each QALY gain is valued at £20,000 then brief advice could generate benefits that in monetary terms is about £93 pounds per person which exceeds the cost of the intervention (£9.50 per person).\n\nIf recruitment to brief advice was changed from the opportunistic centres (base case) to disease register, the ICER increased from £1,730 to £12,010. However, when short term mental health gains associated with physical activity were excluded the ICER was £27,000/QALY gained. The probabilistic sensitivity analysis showed that, at a threshold value of £20,000/QALY, there was a 99.9% chance that brief advice would be cost-effective.","Cost-utility analysis","Published NICE guidance","Markov decision model","No intervention - Usual care","Most changes in assumptions resulted in the ICER falling at or below £12,000/QALY gained. \n\n A Markov decision model with annual cycles was used to compare the lifetime costs and outcomes of a cohort of 100,000 people exposed, at age 33 for one year, to brief advice with an unexposed population.\nBy the end of the first year the cohort was either ‘active’ or ‘inactive’ (based on national definitions) and they could have one of 3 events (non-fatal CHD, non-fatal stroke, type 2 diabetes), remain event free (i.e. without CHD, stroke, or diabetes) or die either from CVD or non-CVD causes.","Lifetime","-","NHS","UK",3.5000000000000003E-2,"£ GBP 2010/11",2012,"Anokye N LJ, Fox-Rushby J. Public Health Intervention Guidance on Physical Activity– Brief advice for adults in primary care: Economic Analysis. National Institute for Health and Clinical Excellence. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH44)","2017"]
["F16","Obesity and Physical Activity","Physical Activity","Dance Class Programme for children and young people","No","-",27570,"-","The cost per QALY is estimated at £27,570.\n\nBest case £15,000 to worst case £151,000\n\nThe effectiveness reviews undertaken did not report any evidence with regard to the effectiveness of dance classes. However, NICE sought to investigate the potential cost-effectiveness of this intervention, where in the absence of such evidence it would be necessary to make a number of assumptions in order to estimate both the costs and benefits of the intervention. ","Cost-utility analysis","Published NICE guidance","School-age children","No intervention","This estimate was  particularly variable, depending upon the assumptions made about the number of children in attendance, the cost of the project and associated increases in physical activity and QALYs gained.","-","-","-","-",3.5000000000000003E-2,"-",2008,"Fordham RJ, Barton GR. 'A cost-effectiveness scenario analysis of four interventions to increase child and adolescent physical activity: the case of walking buses, free swimming, dance classes and community sports. 'Promoting physical activity for children. 'PDG Report, NICE.","Link to source","Based on evidence from evaluations conducted by NICE (PH17)","2017"]
["F17","Obesity and Physical Activity","Physical Activity","Exercise Referral Schemes","No","-",76000,"-","The evidence suggests that these exercise referral schemes have only a marginal added effect relative to other ways of increasing physical activity.\n\nThe economic evaluation suggests that this added benefit was not likely to be a cost effective use of resources.","Cost-utility analysis","Published NICE guidance","Aged 50, presenting in a physically inactive state","No intervention - No referral to exercise service","Using the base case assumptions, the incremental intervention cost of £217 led to an incremental cost-effectiveness ratio (ICER) between £72,748 and £113,931 per QALY gained. Even in the best case scenario, the estimated incremental cost effectiveness ratio was £31,009 per QALY gained. NICE normally considers that any interventions over a threshold of £20,000–£30,000 per QALY are not cost effective. However, because current evidence to inform the assumptions in the model was insufficient, members did not feel they could recommend disinvestment in such schemes. Further, some schemes may be cost effective, or may only be cost effective for some subgroups. Again, however, there was insufficient evidence to make recommendations on this, hence data collection has been made a condition for any exercise referral scheme that is commissioned.","Lifetime","-","NHS and PSS","England",1.4999999999999999E-2,"£ GBP 2013",2015,"Campbell F, Holmes M, Everson-Hock E, Davis S, Woods HB, Anokye N, Tappenden P, Kaltenthaler E. A systematic review and economic evaluation of exercise referral schemes in primary care: a short report. Health technology assessment. 2015;19(60).","Link to source","Based on evidence from evaluations conducted by NICE (PH54)","2017"]
["F18","Obesity and Physical Activity","Physical Activity","Free swimming for children and young people","No","-",40500,"-","The cost per QALY is estimated at £40,500. \n\nWe estimated the cost per additional attendance at a free swimming programme, informed by the costs and increased levels of attendance that had been estimated to have occurred in the aforementioned Glasgow programme. \n\nIn order to estimate the level of increase in physical activity associated the free swimming we estimated the proportion of children who undertook additional physical activity, and the additional level of physical activity that would be associated with each free swimming session.","Cost-utility analysis","Published NICE guidance","Children","No intervention","Evaluation as to the cost-effectiveness of free swim is difficult due to 1) the variation 2) specifying breakdown for costs 3) estimating the benefits, difficult to define the counterfactual 4) implication of offer to others using the pool and staff etc.\n\nLack of directly applicable strong evidence undermines the cost effectiveness modelling and as such it is unclear how generalisable the cost per QALY figures given are. ","Lifetime","-","NHS and PSS","UK",3.5000000000000003E-2,"£ GBP 2007/08",2008,"Fordham RJ, Barton GR. 'A cost-effectiveness scenario analysis of four interventions to increase child and adolescent physical activity: the case of walking buses, free swimming, dance classes and community sports. 'Promoting physical activity for children. 'PDG Report, NICE.","Link to source","Based on evidence from evaluations conducted by NICE (PH17)","2017"]
["F19","Obesity and Physical Activity","Physical Activity","Walking buses for children and young people","No","-",4007,"-","The cost per QALY is estimated at £4,007. The cost per QALY under ‘best case’ and ‘worst case’ scenarios was estimated to be £2,431.51 and £26,306.42, respectively.","Cost-utility analysis","Published NICE guidance","School-age children","No intervention","A walking bus has been defined as “a group of children who walk to school along a set route, collecting other children along the way at ‘bus stops’, escorted by several adult volunteers, one of whom is at the front (‘the driver’) and another is at the back (‘the conductor’)”.\n\nWith regard to the first intervention we estimated that the provision of walking buses would cost £121.71 per child. On average, we estimated that 50% of those who used the walking bus would have previously travelled by car and that for these children it would take an average of 22 minutes to walk to school. Assuming that every additional 30 minutes of physical activity is associated with a QALY gain of 0.00022243 then walking buses are estimated to have a cost per QALY of £4,007.63 per QALY.","Lifetime","-","NHS and PSS","-",3.5000000000000003E-2,"£ GBP 2007/08",2008,"Fordham RJ, Barton GR. 'A cost-effectiveness scenario analysis of four interventions to increase child and adolescent physical activity: the case of walking buses, free swimming, dance classes and community sports. 'Promoting physical activity for children. 'PDG Report, NICE.","Link to source","Based on evidence from evaluations conducted by NICE (PH17)","2017"]
["F20","Obesity and Physical Activity","Physical Activity","Physical activity counselling at work","No","-",495.5,"£484,944 per 1,000 sedentary employees.","Intervention: One 30 minute health promotion consultation and one 30 minute follow-up telephone call consultation conducted by an occupational nurse. \n\nThe total estimated NHS health cost saving results from averting cases of CHD, stroke and type 2 diabetes through implementing a workplace physical activity programme for a cohort of 1,000 sedentary employees.\n\nHowever, there is considerable uncertainty surrounding the health cost saving estimates. ","Cost-utility analysis","Published NICE guidance","Aged 40-60","No intervention","Effectiveness taken from Purath et al. 2004 USA.\n\nWhen the estimated life-time cost savings are taken into account the intervention can be seen to be dominant, i.e. the intervention is both cost saving and results in a health benefit. It should be noted that the cost of the intervention is a one-off cost and life-time savings accrue over a number of years.\n\nSee table 2.12 in the report for the full summary of model assumptions.\n\nThe available effectiveness data were derived from non-UK studies and hence there could be generalisability issues.","Lifetime","-","-","England",3.5000000000000003E-2,"-",2008,"Bending M, Beale S, Hutton J. An economic analysis of workplace interventions that promote physical activity. PHIAC Report. York, England: York Health Economics Consortium. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH13)","2017"]
["F21","Obesity and Physical Activity","Physical Activity","Physical activity counselling at work","No","-",1234.1099999999999,"£292,388 per 1,000 sedentary employees.","Intervention: One 11 hr training session per nurse; One 30 minute physical activity counselling session; Two 30 minute fitness tests performed by a Physiotherapist; One 30 minute physical activity follow-up counselling session\n\nThe total estimated NHS health cost saving results from averting cases of CHD, stroke and type 2 diabetes through implementing a workplace physical activity programme for a cohort of 1,000 sedentary employees.\n\nHowever, there is considerable uncertainty surrounding the health cost saving estimates. ","Cost-utility analysis","Published NICE guidance","Aged 40-62","No intervention","Effectiveness taken from Purath et al. 2004 USA.\n\nWhen the estimated life-time cost savings are taken into account the intervention can be seen to be dominant, i.e. the intervention is both cost saving and results in a health benefit. It should be noted that the cost of the intervention is a one-off cost and life-time savings accrue over a number of years.\n\nSee table 2.12 in the report for the full summary of model assumptions.\n\nThe available effectiveness data were derived from non-UK studies and hence there could be generalisability issues.","Lifetime","-","-","England",3.5000000000000003E-2,"-",2008,"Bending M, Beale S, Hutton J. An economic analysis of workplace interventions that promote physical activity. PHIAC Report. York, England: York Health Economics Consortium. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH13)","2017"]
["F22","Obesity and Physical Activity","Physical Activity","Physical activity walking programme at work","No","-",686.34,"£311,547 per 1,000 sedentary employees.","Intervention: Occupational nurses providing employees with programme services and resources for the promotion of walking. \n\nThe total estimated NHS health cost saving results from averting cases of CHD, stroke and type 2 diabetes through implementing a workplace physical activity programme for a cohort of 1,000 sedentary employees.\n\nHowever, there is considerable uncertainty surrounding the health cost saving estimates. ","Cost-utility analysis","Published NICE guidance","Aged 40-61","No intervention","Effectiveness taken from Purath et al. 2004 USA.\n\nWhen the estimated life-time cost savings are taken into account the intervention can be seen to be dominant, i.e. the intervention is both cost saving and results in a health benefit. It should be noted that the cost of the intervention is a one-off cost and life-time savings accrue over a number of years.\n\nSee table 2.12 in the report for the full summary of model assumptions.\n\nThe available effectiveness data were derived from non-UK studies and hence there could be generalisability issues.","Lifetime","-","-","England",3.5000000000000003E-2,"-",2008,"Bending M, Beale S, Hutton J. An economic analysis of workplace interventions that promote physical activity. PHIAC Report. York, England: York Health Economics Consortium. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH13)","2017"]
["F23","Obesity and Physical Activity","Physical Activity","Birmingham's be active programme","No","£21.3:£1",1164.5999999999999,"-","The aim of the scheme is to tackle health inequality and associated deprivation levels, by offering access to free physical activity sessions for all 1.1 million citizens of the city. Participants can take part in free swimming, exercise classes or the gym at any Council-run leisure centre during off-peak hours, which vary according to each centre. \n\nThe scheme provides an increased opportunity for shared experience. It was estimated that, through this increase in shared experience highly active users of the scheme experience a 5.9 per cent increase in life satisfaction – a measure of SWB.","Cost-benefit analysis","CBA model using primary data","140,000 active users","-","INCLUDES QALY's in the CBR.\n\nFor every £1 spent on Be Active the return for the local NHS is £22.8 in terms of health care related benefits (primary and secondary care). The majority of these benefits relate to health-related quality of life gains. A smaller amount relates to health care cost savings (£2.6) – £0.5 are estimated to be cashable as medication cost savings. For every £1 spent on Be Active the return for the Local Authority is £2.3 in terms of improvements in quality of life among its residents.  Both employers and the Treasury benefit from the scheme, without incurring in any cost, through reduced absenteeism resulting in productivity gains and tax payments, ","Lifetime","LA / NHS","QALY gains for service users, NHS savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2011,"Marsh K, Bertranou E, Samanta K. Cost-benefit analysis and social impact bond feasibility analysis for the Birmingham Be Active scheme. Matrix Evidence. 2011.","Link to source","Further reference (Kings Fund)","2017"]
["F24","Obesity and Physical Activity","Physical Activity","Community based walking programme to improve mental well-being of older people","No","-",7300,"-","The cost per QALY is estimated at £7,300.\n\nA thrice weekly community-based walking programme, delivered to sedentary older people who are able to walk without assistance (Fisher & Li, 2004; Cluster RCT+).","Cost-utility analysis","Published academic journal","-","Minimal intervention","Effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14–0.40).","6 months","-","QALY gain for service users","England","-","£ GBP",2008,"Windle G, Hughes D, Linck P, Morgan R, Burholt V, Edwards RT, Reeves C, Yeo ST, Woods R, Russell I. Public health interventions to promote mental well-being in people aged 65 and over: systematic review of effectiveness and cost-effectiveness. Bangor: University of Wales. 2007.","Link to source","-","2017"]
["F25","Obesity and Physical Activity","Physical Activity","Community based exercise programme to improve mental well-being of older people","No","-",12100,"-","The cost per QALY is estimated at £12,100.","Cost-utility analysis","Published academic journal","-","Minimal intervention","Effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14–0.40).","6 months","-","QALY gain for service users","England","-","£ GBP",2008,"Windle G, Hughes D, Linck P, Morgan R, Burholt V, Edwards RT, Reeves C, Yeo ST, Woods R, Russell I. Public health interventions to promote mental well-being in people aged 65 and over: systematic review of effectiveness and cost-effectiveness. Bangor: University of Wales. 2007.","Link to source","-","2017"]
["F26","Obesity and Physical Activity","Physical Activity","Physical activity for older people","No","-","£26,200-dominated","-","(1) £26,200: Primary care 'green prescription' counselling programme in New Zealand.\n(2) £45,600: Proactive health promotion by nurses in Canada in addition to usual home care for people over 75.\n(3) Dominated: 20 minutes of individual advice on physical activity by an exercise specialist in general practice in Australia.","Cost-utility analysis","Primary modelling","-","Intervention - Control group","Modelling was also used to enhance three RCTs of advice about physical activity. \n(1) Modelled from Kerse et al. (2005; NCT+).\n(2) Modelled from Markle-Reid et al. (2006; RCT++), who evaluated proactive health promotion by nurses in Canada in addition to usual home care for people over 75. \n(3) Halbert et al. (2000; RCT+) reported decreased mental well-being in response to intervention. Thus the advice was dominated by the control group to whom no advice was given.","6 months","-","QALY gains for service users","England","-","£ GBP",2008,"Windle G, Hughes D, Linck P, Morgan R, Burholt V, Edwards RT, Reeves C, Yeo ST, Woods R, Russell I. Public health interventions to promote mental well-being in people aged 65 and over: systematic review of effectiveness and cost-effectiveness. Bangor: University of Wales. 2007.","Link to source","-","2017"]
["F27","Obesity and Physical Activity","Physical Activity","Training healthcare professionals to provide brief advice","No","-","-",308000,"PHE estimates that one champion could train 350 healthcare professionals (150 qualified healthcare professionals; 200 healthcare professionals) to provide brief advice, which could move over 168,000 adults out of inactivity and support 25,226 to achieve the CMOs’ guidelines. PHE estimates that this could prevent 69 cases of type 2 diabetes, 38 cases of CVD, 58 cases of IHD, 6 cases of depression (and result in 1 additional serious road traffic incidence from active travel) over 5 years; additional benefits could be accrued for a further 20 or more conditions.","Cost-benefit analysis","Primary PHE modelling","150 qualified healthcare professionals and 200 trainees","-","Healthcare professionals are expected to have c10,000 patient contacts, and trainees are expected to have c5,000 patient contacts per year. PHE estimates that 40% of those trained will retain the information and act on it and that in 64% of consultations the patient is eligible for the intervention and will receive advice. Finally PHE expects that 30% of targeted patients will respond to a very brief intervention and 15% of those patients taking action will achieve 150 minutes per week of physical activity.\n\nSeek to achieve this by training healthcare professionals, via clinical champions, to provide physical activity brief advice. Clinical champions provide peer-to-peer teaching to primary, secondary and community care professionals to integrate brief advice into routine care to make every contact count. GP clinical champions cover the whole of England and will be joined by a cadre of nurse and allied health professional champions towards the end of 2016.","5 years","NHS","NHS","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["F28","Obesity and Physical Activity","Physical Activity","Brief GP interventions to promote physical activity","No","-","-",-2151,"Brief advice and one motivational interview with a health visitor, compared to just brief advice. \n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","Individuals 40 to 64 years old visiting a GP\n","Intervention - brief advice","Cost: £31 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\n\nOutcomes: the benefits of the intervention derive from achieving an increase in the number of moderate (22%) and\nvigorous activity (6%) sessions which results in 1.52 QALYs per person, £3,301 cost savings per person.  Benefits accrue as a result of reduced probabilities of four diseases associated with physical inactivity - type II diabetes, stroke, coronary heart disease and colon cancer. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["F29","Obesity and Physical Activity","Surgery","Gastric Bypass","No","-",6289,"-","Evidence suggests that surgery in general is a cost-effective intervention relative to a limited non-surgical management option in a typical severely obese group.\n\nGastric Bypass is one of the three major surgical options for weight loss facing healthcare providers.","Cost-utility analysis","Published NICE guidance","Average age 40, 90% female.  Average body weight 135 kg, average BMI 45","No intervention - Usual care","Study was based on a hypothetical cohort made up of 90% women plus a review of 4 papers all taken from outside the UK. However sensitivity analysis suggests that varying parameters around effectiveness was still likely to produce a QALY below the commonly accepted UK threshold.","20 years","-","NHS & PSS","UK","6%;\n1.5%","£ GBP 2005",2006,"National Institute for Health and Clinical Excellence. Obesity Prevention (CG43). Section 6 Health Economics Evidence Statements 2006.","Link to source","Based on evidence from evaluations conducted by NICE (CG43)","2017"]
["F30","Obesity and Physical Activity","Surgery","Adjustable silicone gastric band","No","-",8527,"-","Evidence suggests that surgery in general is a cost-effective intervention relative to a limited non-surgical management option in a typical severely obese group.\n\nAdjustable silicone gastric band  is one of the three major surgical options for weight loss facing healthcare providers.","Cost-utility analysis","Published NICE guidance","Average age 40, 90% female.  Average body weight 135 kg, average BMI 45","No intervention - Usual care","Study was based on a hypothetical cohort made up of 90% women plus a review of 4 papers all taken from outside the UK. However sensitivity analysis suggests that varying parameters around effectiveness was still likely to produce a QALY below the commonly accepted UK threshold.","20 years","-","NHS & PSS","UK","6%;\n1.5%","£ GBP 2005",2006,"National Institute for Health and Clinical Excellence. Obesity Prevention (CG43). Section 6 Health Economics Evidence Statements 2006.","Link to source","Based on evidence from evaluations conducted by NICE (CG43)","2017"]
["F31","Obesity and Physical Activity","Pharmaceutical","Orlistat","No","-",1665,"-","The cost per QALY is estimated at £1,665.\n\nCurrently, Orlistat is the only licensed medication for the management of obesity.\nIn children aged 12 years and older, treatment with Orlistat is recommended only if physical comorbidities (such as orthopaedic problems or sleep apnoea) or severe psychological comorbidities are present. Treatment should be started in a specialist paediatric setting, by multidisciplinary teams with experience of prescribing in this age group.","Cost-utility analysis","Modelling","Diet and exercise advice","-","Comparing Orlistat with placebo, orlistat would be considered cost-effective when using a threshold of £20,000 per QALY and the model is robust to variations in the key parameter values tested with the exception of the baseline BMI value.","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2009",2012,"Ara R, Blake L, Gray L, Hernández M, Crowther M, Dunkley A, et al. What is the clinical effectiveness and cost-effectiveness of using drugs in treating obese patients in primary care? A systematic review. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (CG189)","2017"]
["F32","Obesity and Physical Activity","Procurement","Compliance with Government Buying Standards for Food (GBSF)","No","-","-","£60k per annum","In 2011, food and drink sales in public sector organisations accounted for 6.5% of total sales in the food service sector. At £2.1bn, this provides a large-scale opportunity with significant purchasing power to influence the diets of those who use these services.\n\nWhile higher catering standards cost more in some areas, the Hull and East Yorkshire Hospital NHS Trust achieved savings of £60k per annum by producing some meals in-house, which have been reinvested in wider catering improvements.","-","Evaluation","-","Intervention - Previous procurement","In 2008, meeting catering guidance in a care home setting reduced total fat consumption by 12g, saturated fat by 13g and salt by 0.1g while micronutrients such as\niron, potassium and folate increased by 50% to 75%; all meeting government recommendations.\n\nBuying healthier food following the implementation of GBSF in two canteens in 2013 resulted in an increase in annual sales of 9% and 17% respectively when compared to 2012, in part due to the perception of food being more appetising when made on site.","-","NHS","NHS","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["F33","Obesity and Physical Activity","Road Safety","Pedestrian Crossings","No","-","-","-","Introducing pedestrian crossings and other pedestrian facilities for 579 schemes.\n\nThe net first year rate of return is 246%.","-","-","-","-","Average intervention cost=£27,296\nEffect size= 1.02 lives saved. Based on 1999 data from a number of sites- issues exist in accident data accuracy ","1 year","-","-","England","-","£ GBP",2001,"Gorell RS, Tootill W. Monitoring Local Authority road safety schemes using MOLASSES. TRL REPORT 512. 2001 Dec.","Link to source","-","2017"]
["F34","Obesity and Physical Activity","Weight Management","Weight management interventions after pregnancy","No","-","£9,000-£44,000","-","Using a 15-year time horizon, the estimated cost per quality-adjusted life year (QALY) gained was £44,000. Using a lifetime horizon (the usual measure of cost effectiveness) it was £9,000.","Cost-utility analysis","Published NICE guidance","Women who have given birth, start age of 25 in model.","Intervention - Conventional postnatal care","For weight management after childbirth, the model used a study in which women's weight was measured at both 6 months and 15 years postpartum. This was compared with their pre- and post-pregnancy weight.\n\nClear and transparent use of mathematical modelling, however model based on a small observational study from the US and short term outcomes were extrapolated to give longer term effects. The evidence of intervention effectiveness was based on studies conducted outside the UK. For weight management after childbirth, the model used a study in which women's weight was measured at both 6 months and 15 years postpartum. This was compared with their pre- and post-pregnancy weight. ","15 years / Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP",2010,"Messina J, Johnson M, Campbell F, Everson Hock E, Guillaume L, Duenas A, Rawdin A, Goyder E, Chilcott J. Systematic review of weight management interventions after childbirth. The University of Sheffield: ScHARR Public Health Collaboration Centre. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH27)","2017"]
["F35","Obesity and Physical Activity","Weight Management","Multicomponent small scale intervention","No","-",562,"-","The cost per QALY is estimated at £562.\n\n12-week weight management programme with four main components: 1. A 40min appointment at a men’s health clinic 2. A pre-programme assessment: 20min individual appointments 3. The weight management programme: Each group (max 12 men) met over 3 months, in 12 1- hour evening sessions ... Modelled on an initiative from NHS Forth Valley dietitians 4. Post-programme meetings: Held quarterly at Camelon (for 4 years?)\n","Cost-utility analysis","Systematic Review","Low socio-economic status (110 patients)","No intervention","Direct cost per patient: £180\nOutcomes: 0.1380 average lifetime QALY gain per participant\n\nSensitivity analysis was not probabilistic and so did not allow for uncertainty despite studies having varying degrees of uncertainty. Interventions were considered for use in deprived populations although further modelling suggested that they would be more cost effective if directed at obese populations.","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2010,"Gillett M, Brennan A, Blake L, Payne N, Goyder L, Woods HB, Everson-Hock E, Johnson M, Chilcott J, Hernandez M. Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010 Nov 8:1-69.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)","2017"]
["F36","Obesity and Physical Activity","Weight Management","Multicomponent large scale region wide intervention","No","-","-","Dominant","Dominant - intervention is less costly and more effective than comparator.\n\nAppears to be not only highly cost-effective but also possibly cost-saving (depending on assumptions around cost of maintenance intervention), giving cost saving and health benefits.","Cost-utility analysis","Modelling","Low socioeconomic status","No intervention","Evidence for the effectiveness and cost of the Large-scale, region-wide multi-component (Intervention 9) came from separate sources. The study design for this programme was with a reference region as the ’comparator’.\n\nDirect cost per individual: £3.84\nOutcomes: 0.1266 average lifetime QALY gain per participant","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP",2010,"Gillett M, Brennan A, Blake L, Payne N, Goyder L, Woods HB, Everson-Hock E, Johnson M, Chilcott J, Hernandez M. Prevention of type 2 diabetes: preventing pre-diabetes among adults in high-risk groups. Report on use of evidence from effectiveness reviews and cost-effectiveness modelling. London: NICE Public Health Collaborating Centre, School of Health and Related Research, University of Sheffield. 2010 Nov 8:1-69.","Link to source","Based on evidence from evaluations conducted by NICE (PH35)","2017"]
["F37","Obesity and Physical Activity","Weight Management","E-learning devices as a method of promoting weight loss in obese people","No","-",102112,"-","The cost per QALY is estimated at £102,112. \n\nThe current clinical and economic evidence base suggests that e-learning devices designed to promote dietary behaviour change will not produce clinically significant changes in dietary behaviour and are at least as expensive as other individual behaviour change interventions.","Cost-utility analysis","Published evidence and modelling","-","-","Cost-effectiveness was assessed in two ways: through a systematic literature review and by building a de novo decision model to assess the cost-effectiveness of a ‘generic’ e-learning device compared with dietary advice delivered by a health-care professional. The limitations of this review include potential reporting bias, incomplete retrieval of completed research studies and data extraction errors.","Lifetime","-","NHS and PSS","England",3.5000000000000003E-2,"£ GBP 2009",2011,"Harris J, Felix L, Miners A, Murray E, Michie S, Ferguson E, et al. Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis. Health Technology Assessment. 2011;15(37).","Link to source","-","2017"]
["F38","Obesity and Physical Activity","Weight Management","Weight management interventions for children","No","-","See summary","-","The economic model estimated that interventions costing £100 per person would usually be cost effective from a public sector perspective. This would be the case if a group of overweight or obese children could be moved to a lower average weight trajectory and this was maintained throughout life. (This is true for a weight loss of as little as 0.5%). Interventions that permanently lower weight trajectory by an average 3% are estimated to be cost effective, if their average cost is less than £1000 per child.","Cost-utility analysis","Published evidence and modelling","Children, young people and families","No intervention","The cost effectiveness of interventions for children and young people who are morbidly obese, as defined by the model, was unclear. The PDG concluded that interventions for children who are morbidly obese would need to lower their BMI z score considerably to be worth doing.\n\nThere was little evidence on whether children and young people can maintain for life the lower weight trajectory they may achieve during a lifestyle weight management programme. If they do, the economic model concludes that interventions that cause very small average decreases in weight trajectory will be worth undertaking. However, if the weight is regained quickly and they revert to their previous weight trajectory, then the intervention is estimated not to be cost effective. ","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"National Institute for Health and Clinical Excellence. Weight management: lifestyle services for overweight or obese children and young people (PH47).\n","Link to source","-","2017"]
["F39","Obesity and Physical Activity","Weight Management","GP referral weight management services for children","No","-","£200-£15,800","-","This is a hypothetical intervention of a GP referred intervention costing £353 to reduce weight in children.  Reduction in BMI assumed to carry on into later life which will then decrease the incidence of various obesity related disease.\n\nCost per QALY ranged from £200-£15,800, depending on assumptions used.","Cost-utility analysis","Modelling","Children, young people and families","No intervention","The range in cost-effectiveness of the intervention relates to:\n- Gender of participants\n- BMI of participant\n- Effectiveness of intervention ranging from -0.5%  to 5% reduction in BMI","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F40","Obesity and Physical Activity","Weight Management","Parent only intervention for weight management of children","No","-","£300-£17,400","-","This is a hypothetical intervention of a parent only intervention costing £389 to reduce weight in children.  Reduction in BMI assumed to carry on into later life which will tend decrease the incidence of various obesity related disease.\n\n\nThe cost per QALY ranges from £300 to £17,400, depending on inputs and assumptions used.","Cost-utility analysis","Modelling","Children, young people and families","No intervention","The range in cost-effectiveness of the intervention relates to:\n- Gender of participants\n- BMI of participant\n- Effectiveness of intervention ranging from -0.5%  to 5% reduction in BMI","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH47)","2017"]
["F41","Obesity and Physical Activity","Weight Management","Low cost family intervention for weight management of children","No","-","£600-£19,600","-","This is a hypothetical intervention of a family intervention costing £437 to reduce weight in children.  Reduction in BMI assumed to carry on into later life which will then decrease the incidence of various obesity related disease.\n\nThe cost per QALY ranges from £600 to £19,600, depending on inputs and assumptions used.","Cost-utility analysis","Modelling","Children, young people and families","No intervention","The range in cost-effectiveness of the intervention relates to:\n- Gender of participants\n- BMI of participant\n- Effectiveness of intervention ranging from -0.5%  to 5% reduction in BMI","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH47)","2017"]
["F42","Obesity and Physical Activity","Weight Management","High cost family intervention for weight management of children","No","-","£1,000-£29,200","-","This is a hypothetical intervention of a family intervention costing £651 to reduce weight in children.  Reduction in BMI assumed to carry on into later life which will then decrease the incidence of various obesity related disease.\n\n\nThe cost per QALY ranges from £1,000 to £29,200, depending on inputs and assumptions used.","Cost-utility analysis","Modelling","Children, young people and families","No intervention","The range in cost-effectiveness of the intervention relates to:\n- Gender of participants\n- BMI of participant\n- Effectiveness of intervention ranging from -0.5%  to 5% reduction in BMI","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH47)","2017"]
["F43","Obesity and Physical Activity","Weight Management","Residential  intervention for weight management of children","No","-","£4,200-£89,400","-","This is a hypothetical intervention of a residential intervention costing £1,980 to reduce weight in children. Reduction in BMI assumed to carry on into later life which will then decrease the incidence of various obesity related disease.\n\nThe cost per QALY ranges from £4,200 to £89,400, depending on inputs and assumptions used.","Cost-utility analysis","Modelling","Children, young people and families","No intervention","The range in cost-effectiveness of the intervention relates to:\n- Gender of participants\n- BMI of participant\n- Effectiveness of intervention ranging from -0.5%  to 5% reduction in BMI","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH47)","2017"]
["F44","Obesity and Physical Activity","Weight Management","Weight management interventions for adults","No","-","Cost-effective","-","Lifestyle weight management interventions that help people lose weight and then maintain the weight loss in the long term would be cost effective, if they can be identified. \n\nFrom a public sector perspective, the modelling showed that if the original weight loss achieved by attending a lifestyle weight management programme were to be maintained for life, most of these interventions would be cost effective. That is, provided they cost less than £500 per person and on average, participants lost more than 1 kg in weight. This is true for all age groups and both sexes. However, if they were to regain the lost weight within 2 to 3 years, the modelling indicates that few, if any, of these interventions would be cost effective. To be cost effective, they would need to cost less than £100 per person and the average weight lost would need to be in excess of 5 kg.","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","The model considered cohorts of (virtual) adults of different ages and with a body mass index (BMI) of 25, 30, 35 and 40 kg/m2 . The model tested the effect of a 12-week lifestyle weight management programme. All cohorts were followed for the whole of their lives and they contract diseases and conditions at different rates, depending on their BMI.\n\nThe rate of weight regain is often the most important single factor in determining  cost effectiveness, so until better evidence is available it is difficult to recommend one intervention over another. Other key factors are the amount of weight lost due to the intervention, gender, initial BMI, age, and rate of regain of BMI [% per annum]. In younger participants only a slow weight regain is cost effective but in older participants a greater rate of weight gain is still likely to be cost effective, because most of the obesity-related healthcare costs occur later in life. The likelihood of cost-effectiveness increases with weight and age.","Lifetime","-","NHS ","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F45","Obesity and Physical Activity","Weight Management","Behavioural weight management schemes","No","-","Dominant -> £25,845","-","The cost per QALY ranges from dominant (less costly and more effective than comparator) to £25,845. \n\nBehavioural weight management schemes for adults: 6-12 month programme. ","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","Assumed 0.3 BMI loss (about 0.8kg Loss) costing £100 per head.\n\nReduction in BMI, assumed to carry on into later life -> decreased incidence of various obesity-related diseases\n\nUses cost consequence analysis to examine effect of various rates of weight regain. General consideration is that the slower the weight regain rate the more cost effective and interventions are generally most cost effective in older, heavier populations.  ","Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F46","Obesity and Physical Activity","Weight Management","Behavioural weight management schemes","No","-","Dominant -> £5,452","-","The cost per QALY ranges from dominant (less costly and more effective than comparator) to £5,452. \n\nBehavioural weight management schemes for adults: >12 month programme. ","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","Assumed 0.6 BMI loss (about 1.6kg Loss) for life, costing £100 per head.\n\nReduction in BMI, assumed to carry on into later life -> decreased incidence of various obesity-related diseases\n\nUses cost consequence analysis to examine effect of various rates of weight regain. General consideration is that the slower the weight regain rate the more cost effective and interventions are generally most cost effective in older, heavier populations.  ","Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F47","Obesity and Physical Activity","Weight Management","Behavioural weight management schemes","No","-","Dominant -> £2,897","-","The cost per QALY ranges from dominant (less costly and more effective than comparator) to £2,897. \n\nBehavioural weight management schemes for adults involving weight loss via group sessions.","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","Assumed 1 BMI loss (about 2.6 kg loss) for life, costing £100 per head.\n\nReduction in BMI, assumed to carry on into later life -> decreased incidence of various obesity-related diseases\n\nUses cost consequence analysis to examine effect of various rates of weight regain. General consideration is that the slower the weight regain rate the more cost effective and interventions are generally most cost effective in older, heavier populations.  ","Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F48","Obesity and Physical Activity","Weight Management","Behavioural weight management schemes","No","-","Dominant -> £832","-","The cost per QALY ranges from dominant (less costly and more effective than comparator) to £832. \n\nBehavioural weight management schemes involving supervision.","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","Assumed BMI loss of 2 kg/m2 corresponding to a weight loss of approximately 5.2kg, costing £100 per head.\n\nReduction in BMI, assumed to carry on into later life -> decreased incidence of various obesity-related diseases\n\nUses cost consequence analysis to examine effect of various rates of weight regain. General consideration is that the slower the weight regain rate the more cost effective and interventions are generally most cost effective in older, heavier populations.  ","Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F49","Obesity and Physical Activity","Weight Management","Largest average loss for behavioural weight management schemes","No","-","Dominant -> £200","-","The cost per QALY ranges from dominant (less costly and more effective than comparator) to £200.","Cost-utility analysis","Modelling","Age 20-69 by males and females and BMI category","No intervention","Assumed BMI loss of 3 kg/m2 corresponding to a weight loss of approximately 7.8kg, costing £100 per head.\n\nReduction in BMI, assumed to carry on into later life -> decreased incidence of various obesity-related diseases.\n\nUses cost consequence analysis to examine effect of various rates of weight regain. General consideration is that the slower the weight regain rate the more cost effective and interventions are generally most cost effective in older, heavier populations.  ","Lifetime","-","-","England",3.5000000000000003E-2,"£ GBP 2011/12",2013,"Brown M, Marsh T, Rtveladze K, Fordham R, Suhrcke M, Turner D, et al., editors. Managing overweight and obesity among children Report on Economic Modelling and Cost Consequence Analysis 2013: NICE, UK Health Forum, University of East Anglia.","Link to source","Based on evidence from evaluations conducted by NICE (PH53)","2017"]
["F50","Obesity and Physical Activity","Weight Management","Lifestyle weight management services","No","-","-","£30 p.a per person","Lifestyle weight management programmes (tier 2 services) for overweight or obese adults are multi-component programmes that aim to reduce a person's energy intake and help them to be more physically active by changing their behaviour. \n\nOver a 5 year period, average annual health and care savings are c£30 p.a. per person enrolled (i.e. cumulative saving of c£150 per person over 5 years). Weight management interventions aim to have lifelong impact and are unlikely to manifest as high savings in the short term. This intervention could be cost saving to the health and care system by year 2.","-","Primary PHE modelling","overweight adults","no intervention","Costs: estimated at a total upfront cost of £100 per person enrolled.\n\nPHE has assumed a tier 2 intervention funded by local authorities that recruits 45 men and 255 women with an average age of 51 years, a mean starting BMI of 33.2 kg/m2 and a 36% drop out rate. Effectiveness: participants completing a 12-month intervention could reduce their body mass index by an average of 2.46 kg/m2 . ","25 years","LA / NHS","Healthcare and social care savings ","England","-","£ GBP 2010",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["F51","Obesity and Physical Activity","Weight Management","Extended (52 week) and standard duration (12 week) weight-loss programmes for adults","No","-","£2,394-£3,804","Cost-saving","For overweight or obese adults, referral to this open-group behavioural weight-loss programme for at least 12 weeks is dominant (more effective and cost-saving) compared to brief advice and self-help materials. \n\nA 52-week programme was cost-effective relative to the brief intervention (ICER £2,394 per QALY). It produces greater weight loss and other clinical benefits than a 12-week programme (ICER £3,804 per QALY) and, although it costs more, modelling suggests that the 52-week programme is cost-effective in the longer term.","Cost-effectiveness analysis; Cost-utility analysis","Published academic journal","1267 eligible participants were randomly assigned to the brief intervention (n=211), the 12-week programme (n=528), and the 52-week programme (n=528).","Intervention - current practice (12-week referral); brief advice and self-help materials.","Cost: £18.50 (brief intervention, incl. GP referral time); £60 (12-week programme); £195 (52-week programme).\n\nAt 12-month follow-up (primary outcome), 57% of participants in the 52-week programme had lost 5% or more of weight, compared with 42% in the 12-week programme and 25% in the brief intervention.\n\nOver 2 years, the incremental cost-effectiveness ratio (ICER; compared with brief intervention) was £159 per kg lost for the 52-week programme and £91 per kg for the 12-week programme. \n\nOver 25 years, the 12-week programme resulted in 623 fewer incident cases of disease, 643 additional QALYs, and a cost-saving of approximately £268,000 per 100,000 individuals. By comparison with the 12-week programme, the 52-week programme resulted in 1,786 fewer incident cases of disease and generated 1,282 additional QALYs, at a cost of approximately £4.9 million per 100,000 individuals.","2 / 25 years","LA","QALY gains for service users","UK",3.5000000000000003E-2,"£ GBP",2017,"Ahern AL, Wheeler GM, Aveyard P, Boyland EJ, Halford JCG, Mander AP, et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. The Lancet.389(10085):2214-25.","Link to source","-","2017"]
["F52","Obesity and Physical Activity","Weight Management","Weight Management Programme 1 (WMP 1)","No","-",2379,"-","Participants are given professional advice on dietary interventions e.g. meal replacements and weight loss programmes such as weight watchers","Systematic review & RCT","Modelling","People in the general population who are obese","No intervention","No social care costs\n\nThe baseline comparator for the model is a natural history cohort using risk factors (BMI) to project the\nfuture obesity trends and development of obesity-related disease.\n\nModelling results conducted by a microsimulation model\n\nAnalysis models a linear 100% weight gain over 5 years from the last time point with observed data for each non-surgical WMP.","30 years","NHS","QALYs and intervention cost ","UK","3.5% costs\n3.5% benefits","£ GBP",2018,"Bariatric surgery, lifestyle interventions and orlistat\nfor severe obesity: the REBALANCE mixed-methods\nsystematic review and economic evaluation - Alison Avenell et al 2018","Link to source","Interventions are sourced from a paper which conducted a systematic review and as a result includes additional interventions which can be considered",2019]
["F53","Obesity and Physical Activity","Weight Management","Weight Management Programme (WMP 2)","No","-",3726,"-","Participants are given professional advice on physical activities and lifestyle interventions","Systematic review & RCT","Modelling","People in the general population who are obese","No intervention","No social care costs\n\nThe baseline comparator for the model is a natural history cohort using risk factors (BMI) to project the\nfuture obesity trends and development of obesity-related disease.\n\nModelling results conducted by a microsimulation model\n\nAnalysis models a linear 100% weight gain over 5 years from the last time point with observed data for each non-surgical WMP.","30 years","NHS","QALYs and intervention cost ","UK","3.5% costs\n3.5% benefits","£ GBP",2018,"Bariatric surgery, lifestyle interventions and orlistat\nfor severe obesity: the REBALANCE mixed-methods\nsystematic review and economic evaluation - Alison Avenell et al 2018","Link to source","Interventions are sourced from a paper which conducted a systematic review and as a result includes additional interventions which can be considered",2019]
["F54","Obesity and Physical Activity","Weight Management","Look AHEAD","No","-",33354,"-","Tailored , home-based exercises, including walking are prescribed with a gradual progression towards a goal of 175 minutes of moderate-intensity exercise  per week.","Systematic review & RCT","Modelling","People in the general population who are obese","No intervention","No social care costs\n\nThe baseline comparator for the model is a natural history cohort using risk factors (BMI) to project the\nfuture obesity trends and development of obesity-related disease.\n\nModelling results conducted by a microsimulation model\n\nAnalysis models a linear 100% weight gain over 5 years from the last time point with observed data for each non-surgical WMP.","30 years","NHS","QALYs and intervention cost ","UK","3.5% costs\n3.5% benefits","£ GBP",2018,"Bariatric surgery, lifestyle interventions and orlistat\nfor severe obesity: the REBALANCE mixed-methods\nsystematic review and economic evaluation - Alison Avenell et al 2018","Link to source","Interventions are sourced from a paper which conducted a systematic review and as a result includes additional interventions which can be considered",2019]
["F55","Obesity and Physical Activity","Weight Management","Roux-en-Y gastric bypass (RYGB) ","No","-",14207,"-","A type of bariatric surgery which is a more complicated procedure and involves the creation of a small pouch at the top of the stomach with staples.","Systematic review & RCT","Modelling","People in the general population who are obese","No intervention","No social care costs\n\nThe baseline comparator for the model is a natural history cohort using risk factors (BMI) to project the\nfuture obesity trends and development of obesity-related disease.\n\nModelling results conducted by a microsimulation model\n\nAnalysis models a linear 100% weight gain over 5 years from the last time point with observed data for each non-surgical WMP.","30 years","NHS","QALYs and intervention cost ","UK","3.5% costs\n3.5% benefits","£ GBP",2018,"Bariatric surgery, lifestyle interventions and orlistat\nfor severe obesity: the REBALANCE mixed-methods\nsystematic review and economic evaluation - Alison Avenell et al 2018","Link to source","Interventions are sourced from a paper which conducted a systematic review and as a result includes additional interventions which can be considered",2019]
["F56","Obesity and Physical Activity","Weight Management","Very Low Calorie Diet (VLCD)","No","-",6649.56,"-","Defined as meal replacements products providing <= 800 kcal/day (+,- 10%)","RCT","Modelling","People in the general population who are obese","No intervention","No social care costs\n\nThe baseline comparator for the model is a natural history cohort using risk factors (BMI) to project the\nfuture obesity trends and development of obesity-related disease.\n\nModelling results conducted by a microsimulation model\n\nAnalysis models a linear 100% weight gain over 5 years from the last time point with observed data for each non-surgical WMP.","30 years","NHS","QALYs ","UK","1.5% costs\n1.5% benefits","£ GBP",2018,"Bariatric surgery, lifestyle interventions and orlistat\nfor severe obesity: the REBALANCE mixed-methods\nsystematic review and economic evaluation - Alison Avenell et al 2018","Link to source","Interventions are sourced from a paper which conducted a systematic review and as a result includes additional interventions which can be considered",2019]
["F57","Obesity and Physical Activity","Weight Management","Brief intervention for Weight Loss (BWeL)","No","-","Dominant","-","A brief intervention in which physicians opportunistically endorse, offer, and facilitate a referral to a behavioural weight management service to patients with a BMI of at least 30 kg/m2 reduces healthcare costs and improves health more than advising weight loss. \n\nIn the support intervention physicians advised patients that the best way to lose weight was to attend one of two well-known UK commercial weight management programmes which are available as a 12-week group programme paid for by the English NHS and offered them a referral to the group. These were Slimming World and Rosemary Conley.\n\nIn the advice arm of the intervention, physicians advised the patient their health would benefit from weight loss. Patients welcomed the intervention; one in 500 thought the intervention inappropriate and unhelpful, while more than four in five thought it appropriate and helpful.","Cost-effectiveness analysis","Modelling","1882 participants who are classified as obese.\n\nAsian population: BMI > 25kg/m^2\n\nAll other ethnicities: BMI > 30kg/m^2","Advice group of the intervention","Modelled a one-off delivery of both support and advice intervention in the trial. To do so, virtual cohorts of 20 million people were created by randomly sampling with replacement from the adult population enrolled in the BWeL trial.\n\nBMI growth equation to the BMI of cohort members was simulated using a Monte Carlo process.\n\nThe data on BMI change were projected forward based on past trends in BMI for age and gender-specific groups in the English population taken from the Health Survey for England from 2004 to 2014.","20 years","NHS","QALYs, intervention costs, savings","England","1.5% costs\n1.5% benefits","£ GBP",2019,"-","Link to source","-",2019]
["F58","Obesity and Physical Activity","Weight Management","Football Fans in Training (FFIT)","No","-",2810,"-","A two-arm, pragmatic, randomised controlled trial; associated cost-effectiveness [in terms of incremental cost per quality-adjusted life-year (QALY) within trial and over individuals’ lifetimes]; and process evaluation. \n\nThe prevalence of male obesity is increasing alongside low uptake of existing weight management programmes by men. Football Fans in Training (FFIT) is a group-based, weight management and healthy living programme delivered by community coaches.","Cost-effectiveness analysis, RCT","Modelling","A total of 747 men aged 35 - 65 years with a BMI of =>28kg/m^2\n\n374 men were allocated the intervention and 333 completed the 12 month assessment","374 were allocated to the comparator","89% completion rate","12 months","-","QALYs, and weight loss","Scotland","N/A","£ GBP",2015,"-","Link to source","-",2019]
["F59","Obesity and Physical Activity","Physical Activity","Improved walking and cycling infrastructure","No","$1.87:$1","-","-","This is a cost-benefit analysis of a model estimation based on National Household Travel Survey (USA). It is estimated that investing $450 million in making pavements available to all residents of Dane County, Wisconsin would produce a BCR of 1.87","Cost-benefit analysis","Published Academic Journal","All residents of Dane County, Wisconsin, USA. n= 4974","No intervention","The annual total combined benefit was $99.16 million in 2002 which is a sum of $90.93 million in terms of health benefits and $8.23 million in terms of benefits in air pollution. Over 10 years with an annual discount rate of 3% this produces total benefits of $845.85 million. The total construction costs are $450.8 million therefore the BCR is (845.85/450.8) = 1.87","10 years","-","Benefit-Cost Ratio","USA",0.03,"2001-2 \n$ USD",2010,"Guo JY, Gandavarapu S. An economic evaluation of health-promotive built\nenvironment changes. Prev Med 2010;50:44–9.","Link to source","-",2019]
["F60","Obesity and Physical Activity","Education","Medication management for high-risk groups, medication therapy management (MTM).","No","$2.00:$1","-","-","This intervention is a medication therapy management (MTM) programme which involves at least 3 consultations with a clinical pharmacist to assess and discuss patients' drug therapy regime, in order to improve adherence. This study was targeted at individuals at high risk, who were invited to participate. This study focused on 5 conditions: diabetes, hypertension, dyslipidaemia, depression and asthma. The benefits of this programme in terms of reduced healthcare costs are $977 and the cost of administering this programme are $478, which results in a BCR of 2.0","Cost-benefit analysis","Published Academic Journal","The matched study population consisted of 4,500 patients. The MTM and control group comprised eligible members of\na large employer prescription benefit plan who were identified between October 1, 2007, and November 12, 2008.","Comparator Group Intervention not stated ","The $977 reduction in healthcare costs compared to the control group represents a decrease of 10.3%. Healthcare costs are a total of medical costs (inpatient hospitalisation) and pharmacy costs which are the cost of dispensed medication.","1 year","-","Benefit-Cost Ratio","USA","Not Stated","$ USD",2013,"Moore JM, Shartle D, Faudskar L, et al. Impact of a patient-centred pharmacy\nprogram and intervention in a high-risk group. J Manag Care Pharm\n2013;19:228–36.","Link to source","-",2019]
["F61","Obesity and Physical Activity","Education","Outpatient pharmacy services for medication adherence","No","ROI $5.79:1 ","-","-","This is an Outpatient Pharmacy Clinical Services (OPCS) programme which targets nonadherent patients with diabetes mellitus or coronary artery disease who have HbA1c and LDL levels which are in excess of clinical targets. Investing $1 in the OPCS programme resulted in an ROI of $5.79","Cost-benefit analysis","Published Academic Journal"," Patients aged 18 years and over who received OPCS consultations and usual care patients from March 2009 through December 2010, with 1 year of follow-up from the initial consult (index date) from Southern California. \nPatients also had to be enrolled with a pharmacy benefit for at least 1 year before and 1 year after the index date and listed in the KPSC Diabetes Registry or the KPSC Coronary Artery Disease Registry. ","Usual Care","ROI was calculated as: (total savings – cost)/cost\nThe total cost of the OPCS program is $1,713,468 and the total benefit is $11,640,296 in terms of costs savings from reduced hospital visits which resulted in an ROI of 5.79.\nThis assumes that 58% of the hospitalisation and 8.5% of A&E (ER) visits which occurred in the usual care group were avoidable because of the outpatient pharmacist’s intervention. ","1 year","-","ROI","USA","Not Stated","$ USD",2014,"Spence MM, Makerem AF, Reyes SL, et al. Evaluation of an outpatient pharmacy\nclinical services program on adherence and clinical outcomes among patients with\ndiabetes and/or coronary artery disease. J Manag Care Speciality Pharm\n2014;20:1036–45.","Link to source","-",2019]
["F62","Obesity and Physical Activity","Education","Heart failure disease management","No","$1.15-$1.08:1","-","-","This project estimates the BCR (described as an ROI in the original paper) of a pilot Congestive Heart Failure (CHF) disease management program for members of the Blue Cross Blue Shield Federal Employee Program (funding organisation). Investing $1 in the pilot CHF disease management program produces a BCR of $1.08 from a medical expenditure perspective and $1.15 from an insurer (broader) perspective, with a time horizon of 1 year.","Cost-benefit analysis","Published Academic Journal","A cohort of 457 participants from the state of Maryland, USA was matched to a cohort of 803 nonparticipants from a neighbouring state (Virginia, USA) where the \nCHF program was not offered.","No Intervention","The Benefit-Cost Ratio is described as an ROI in the original study. \nThe total benefits of the program are $841,499.92 from the perspective of the Federal Employee Program (funding organisation) and $896,979.75 from the perspective of all payers. The total costs are $779,207.87 for both perspective, which produces BCR of $1.08 and $1.15 respectively. The BCR of $1.15 includes a broader perspective covering savings to medical expenditure and savings to patients in terms of fewer co-payments and deductibles. There was no discounting due to the 1-year time horizon.","1 year","-","BCR/ROI\nSavings in medical expenditure and patient expenses","USA","Not Discounted","2001\n$ USD",2005,"Van Vonno CJ, Ozminkowski RJ, Smith MW, et al. What can a pilot congestive\nheart failure disease management program tell us about likely return on\ninvestment? A case study from a program offered to federal employees. Dis Manag\n2005;8:346–60.","Link to source","-",2019]
["F63","Obesity and Physical Activity","Physical Activity","Bike and pedestrian trails","No","BCR $2.94:1","-","-","A cost benefit analysis of constructing pedestrian and bike trails in Lincoln, Nebraska, USA to address healthcare costs  related to inactive lifestyles was undertaken. Investing $1 in bike/pedestrian trails for physical activity produces a BCR of $2.94 in terms of direct medical benefits. ","Cost-benefit analysis","Published Academic Journal","225,351 users of 5 bike and pedestrian trails, USA ","No intervention","The cost for each time a trail was used was $0.27, which was determined using an average construction and maintenance cost of the 5 trails and annual usage taken from the Lincoln Recreational Trails Census Report. The annual cost for one person to use the trail was determined by assuming the trail would be used 3 times per week and 52 weeks each year. This results in $42.12 (3 ×, 52 × 0.27) which was then added to travel and equipment costs of $150 to produce a total cost of $192.12 ($42.12 + $150). \nUsing the trails generated annual direct health benefits of $564.41 in 1998. This overall produces a BCR of $564.41/$192.12 = $2.94","10 years","-","Average Annual Trail Usage, Costs and BCR","USA","Not Stated","1998\n$ USD",2005,"Wang G, Macera CA, Scudder-Soucie B, et al. A cost benefit analysis of physical\nactivity using bike/pedestrian trails. Health Promote Pract 2005;6:174.","Link to source","-",2019]
["F64","Obesity and Physical Activity","Dietary and Nutrition","Excise tax on sugar sweetened beverages","No","$55","-","-","This paper reports the preliminary results from the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES). An excise tax of $0.01 per ounce of sugar-sweetened beverage leads to reductions in SSB consumption by 20% which results in a mean reduction in BMI by 0.16 for youths and 0.08 for adults. The reduction in obesity is 1.38% for youths and 0.99% for adults These changes lead to a reduction in consequent healthcare costs of $3.16 for every unit reduction in BMI and would save $55 for every $1 invested. ","Cost-benefit analysis","Published Academic Journal","A simulated cohort representative of the 2015 U.S. population","Current Practice / Usual Care","Obesity is defined as a BMI of greater than or equal to 30.  The excise tax is not applied to 100% juice, dairy products and beverages with artificial sweeteners. Average daily consumption of SSBs was 150 kcal/day.  \nThe model simulated the 2015 US population aged 2 years and older at baseline for 10 years until death or age 100 years. The model predicts changes in conditions linked to obesity including stroke, ischemic heart disease, hypertensive heart disease, diabetes mellitus, osteoarthritis, postmenopausal breast cancer, colon cancer, endometrial cancer and kidney cancer. \nThe tax proposed of $0.01 per ounce would increase prices by approximately 16%.  No benefits in terms of BMI reduction was estimated during Year 1 of the intervention due to the time lag between reduced SSB consumption i.e. energy intake and reduced BMI.","10 years","-","BCR- Net Cost saved per $1 spent\nReduction in BMI","USA",0.03,"$ USD 2014",2015,"Gortmaker SL, Long MW, Resch SC, et al. Cost effectiveness of childhood obesity\ninterventions: evidence and methods for CHOICES. Am J Prevent Med\n2015;49:102–11.","Link to Source","https://www.sciencedirect.com/science/article/pii/S0749379715000963",2019]
["F65","Obesity and Physical Activity","Dietary and Nutrition","Eliminating tax subsidy of nutritionally poor food advertising to children","No","$38","-","-","This paper reports the preliminary results from the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES). This intervention involves removing the tax-deductible elements of advertising costs of TV advertisements for food and drink of low nutritionally quality, aimed at children. The result would be a reduction in mean BMI of 0.028 for children aged 2-19 years which is approximately 0.14% and a reduction in obesity prevalence of 0.30%. The cost of reduction would be $1.16 for each unit of BMI of reduced and would save $38 for every $1 invested. ","Cost-benefit analysis","Published Academic Journal","A simulated cohort representative of the 2015 U.S. population","Current Practice / Usual Care","The intervention is applied to programmes watched on TV including children's programming defined as having children at greater than 35% of its audience share. This intervention was not modelled on adults or digital advertising in non-TV formats. The intervention was assumed to be in effect for 10 years.\nThis time horizon was chosen as 10 years due to uncertainties surrounding the lifetime maintenance effects of interventions implemented in childhood. The study did not account for any product reformulation that may result from the intervention. The price elasticity of demand was -0.74 for children aged 2-9 years and -0.61 for 10-19 years. The effective rate of corporation tax was assumed to be 12.6%","10 years","-","BCR- Net Cost saved per $1 spent\nReduction in BMI","USA",0.03,"$ USD 2014",2015,"Gortmaker SL, Long MW, Resch SC, et al. Cost effectiveness of childhood obesity\ninterventions: evidence and methods for CHOICES. Am J Prevent Med\n2015;49:102–11.","Link to Source","https://www.sciencedirect.com/science/article/pii/S0749379715001300",2019]
["G1","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","£5.60:£1",18230,"-","Motivational enhancement therapy (MET) is counselling to evoke rapid and internally motivated change. \n\nIt had an incremental cost-effectiveness ratio (ICER) of £18,230 (marginal cost of 206 divided by marginal utility gain of 0.0113 QALYs) in comparison with social therapy.","Cost-benefit analysis; cost-utility analysis","Published academic journal","742 clients with alcohol problems; 617 (83.2%) were interviewed at 12 months and full economic data were obtained on 608 (98.5% of 617).","No intervention (CBR); intervention - social therapy (ICER)","Outcomes (%  before treatment; % after treatment): \nUsed health care (97%; 85%) \nContacted alcohol treatment services (94%; 27%) , used social services (47%; 28%), contact with criminal justice  (21%; 10%).\n\nCost: £129 pp., Benefits: £722 pp. Savings in health care (30%), criminal justice (23%), social care (2%)and other alcohol treatment (43%). Does not sum to 100% due to rounding.","1 year","LA","LA / NHS / social care / criminal justice savings","England","None","£ GBP 2000/01",2005,"Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT). BMJ. 2005;331(7516):544.","Link to source","-","2017"]
["G2","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-","$80-$3,400","-","Motivational enhancement therapy (MET) is counselling to evoke rapid and internally motivated change. \n\nIt was cost-effective compared with no active treatment with an incremental cost-effectiveness ratio (ICER) ranging from approximately AUS$80 per QALY for the simple intervention to approximately AUS$280 per QALY for the extended intervention. Compared to no further counselling after initial assessment, MET was cost-effective with an ICER of approximately AUS$3,400 per QALY.","-","Published academic journal","-","No intervention","NICE identified eight RCTs including over 4,200 participants, of which three RCTs including 433 participants compared MET to a control. Compared to control, MET was more effective at reducing the average number of drinks per day at one month follow-up SMD= -0.67 (-1.20, -0.15). The quality of this evidence was moderate.","-","LA","QALY gains for service users","Australia","-","$ AUD",2011,"National Collaborating Centre for Mental Health. Alcohol Use Disorders: The NICE Guideline on the Diagnosis, Assessment\nand Management of Harmful Drinking and Alcohol Dependence (NICE Clinical Guidelines). Leicester and London: The\nBritish Psychological Society and the Royal College of Psychiatrists; 2011.","Link to source","PHE alcohol evidence review","2017"]
["G3","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-","£5,100-£6,274","-","Nalmefene is an opioid used by adult patients with alcohol dependence.\n\nNalmefene given in conjunction with psychosocial support produces an ICER of £5,100 per QALY gained (NICE committee concluded that this is likely to be an underestimate due to the utility values included in the model) and is more cost-effective than psychosocial support alone for treating people with\nalcohol dependence who have a high drinking risk level, without physical withdrawal symptoms and who do not require immediate detoxification.\n\nWhen applying the upper estimate for the number of medical visits per month, the ICER increased to £6,274 per QALY gained.","-","Published NICE guidance","-","Intervention (psychosocial support only)","Nalmefene is an opioid antagonist which can be used by adult patients with alcohol dependence who have a high-risk level of alcohol consumption but do not have physical withdrawal symptoms and do not require immediate detoxification. Nalmefene can also be taken ‘as needed’, when a person feels the urge to consume alcohol. \n\nNICE identified three RCTs including almost 2,000 participants. At six months, nalmefene, coupled with psychosocial management, compared to placebo, plus psychosocial management, reduced the number of heavy drinking days by 3.0 days per month (-4.36, -1.66) and total alcohol consumption reduced by 14.2 g per day (-20.0, -8.5). The quality of this evidence was high.","-","LA","-","England","-","£ GBP",2014,"Stevenson M, Pandor A, Stevens JW, Rawdin A, Rice P, Thompson J, et al. Nalmefene for reducing alcohol consumption in people with alcohol dependence: an evidence review group perspective of a NICE single technology appraisal. Pharmacoeconomics. 2015;33(8):833-47.","Link to source","-","2017"]
["G4","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-","-","Cost-saving","Behaviour self-control therapy is a treatment approach for alcohol problems, consisting of behavioural techniques of goal setting, self-monitoring, managing consumption, rewarding goal attainment, functionally analysing drinking situations, and learning alternate coping skills.\n\nNet savings were estimated at £80,452.","-","Published NICE guidance"," Hypothetical cohort of 1000 patients","No intervention - standard care","-","20 years","LA","Healthcare savings","Scotland",3.5000000000000003E-2,"£ GBP",2011,"The British Psychological Society, The Royal College of Psychiatrists. Alcohol-use disorders: The NICE guideline on diagnosis, assessment and management of harmful\ndrinking and alcohol guidance. National Clinical Practice Guideline 115. NICE; 2011. ","Link to source","-","2017"]
["G5","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-","-","Cost-saving","Coping and skills training  tries to strengthen the patient’s skills in coping with situations associated with a high risk of drinking.\n\nNet savings were estimated at £274,008.","-","Published NICE guidance"," Hypothetical cohort of 1000 patients","No intervention - standard care","-","20 years","LA","Healthcare savings","Scotland",3.5000000000000003E-2,"£ GBP",2011,"The British Psychological Society, The Royal College of Psychiatrists. Alcohol-use disorders: The NICE guideline on diagnosis, assessment and management of harmful\ndrinking and alcohol guidance. National Clinical Practice Guideline 115. NICE; 2011. ","Link to source","-","2017"]
["G6","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Multicomponent community programmes","No","-","€39: €1","-","A multi-part programme in Stockholm combining community mobilization, training of responsible beverage service (RBS) which means not serving alcohol to intoxicated and underage patrons, and stricter enforcement of existing alcohol laws.\n\nA cost-effectiveness analysis of the programme showed that the\nintervention saved €39 for every €1 invested.","-","-","-","-","Analysis is based on effectiveness study, reporting a 29% reduction in police-reported violence.\n\nThe overall cost of the programme was estimated at €796,000 (mostly administration and training costs) and the average cost of a single violent crime was estimated\nto be €19,049, resulting in an overall saving of €31.3 million relating to savings to:\n- the judicial system (78%)\n- production losses (15%)\n- health care issues (5%)\n- other damages (2%)\n\nThe average loss of health state weighting among the victims at 0.09 translates into 236 gained QALYs for society as a whole.","-","LA","Healthcare savings, QALY gains for service users, criminal justice system, productivity gains","Sweden",0.03," € EUR",2007,"Månsdotter AM, Rydberg MK, Wallin E, Lindholm LA, Andréasson S. A cost-effectiveness\nanalysis of alcohol prevention targeting licensed premises. Eur J Public Health. 2007\nDec;17(6):618–23. ","Link to source","-","2017"]
["G7","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-",5043,"-","Acamprosate is a medication used to treat alcohol dependence. The pharmacological mechanism of action of acamprosate is not fully known, but it appears to reduce the craving for alcohol in patients who have consumed large amounts of alcohol over a long period of time. Acamprosate is most effective in combination with psychosocial support and can help facilitate reduced consumption as well as abstinence.\n\nIt has an ICER of £5,043 per QALY versus standard care and £1,899 per QALY versus Naltrexone.\n\n","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1000 patients","Standard care","Standard Care:\n 12-month mean costs per 1000 patients: £1,664,382\nQALYs per 1000 patients: 656\n\nNaltrexone:\n12-month mean costs per 1000 patients: £1,797,737\nQALYs per 1000 patients: 680\n\nAcamprosate:\n12-month mean costs per 1000 patients: £1,802,982m\nQALYs per 1000 patients: 683","1 year","LA","QALY gains for service users","England","None","£ GBP",2011,"The British Psychological Society, The Royal College of Psychiatrists. Alcohol-use disorders: The NICE guideline on diagnosis, assessment and management of harmful\ndrinking and alcohol guidance. National Clinical Practice Guideline 115. NICE; 2011. ","Link to source","-","2017"]
["G8","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Social behaviour network therapy","No","£4.62:£1","-","-","Social behaviour network therapy (SBNT) is a psychosocial intervention which builds upon the premise that social network support for change is central to the resolution of addictive behaviour. \n\nParticipants reported highly significant reductions in drinking and associated problems and costs. The novel SBNT did not differ significantly in cost effectiveness from the proved motivational enhancement therapy (MET), counselling to evoke rapid and internally motivated change. ","Cost-benefit analysis","Published academic journal","742 clients with alcohol problems; 617 (83.2%) were interviewed at 12 months and full economic data were obtained on 608 (98.5% of 617).","No intervention","Outcomes (%  before treatment; % after treatment): \nUsed health care (97%; 85%) \nContacted alcohol treatment services (94%; 27%) , used social services (47%; 28%), contact with criminal justice  (21%; 10%).\n\nCost: £221 pp., Benefits: £1,020 pp. Savings in health care (27%), criminal justice (38%), social care (2%)and other alcohol treatment (32%). Does not sum to 100% due to rounding.","1 year","LA","LA / NHS / social care / criminal justice savings","England","None","£ GBP 2000/01",2005,"Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT). BMJ. 2005;331(7516):544.","Link to source","-","2017"]
["G9","Alcohol Misuse","Specialist treatment for alcohol dependence in adults","Treatment for alcohol problems","No","-",5395,"-","Naltrexone is a drug that is used in the management of alcohol dependence by\ndecreasing the desire for alcohol, heavy drinking and the volume and frequency of\ndrinking occasions.\n\nIt has an ICER of £5,395 per QALY versus standard care and was extendedly dominated (i.e. less cost-effective) versus acamprosate.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1000 patients","Standard care","Standard Care:\n 12-month mean costs per 1000 patients: £1,664,382\nQALYs per 1000 patients: 656\n\nNaltrexone:\n12-month mean costs per 1000 patients: £1,797,737\nQALYs per 1000 patients: 680\n\nAcamprosate:\n12-month mean costs per 1000 patients: £1,802,982m\nQALYs per 1000 patients: 683","1 year","LA","QALY gains for service users","England","None","£ GBP",2011,"The British Psychological Society, The Royal College of Psychiatrists. Alcohol-use disorders: The NICE guideline on diagnosis, assessment and management of harmful\ndrinking and alcohol guidance. National Clinical Practice Guideline 115. NICE; 2011. ","Link to source","-","2017"]
["G10","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Alcohol care teams","No","£3.85:£1","-","Cost-saving","Secondary care alcohol specialist services alleviate the enormous impact of alcohol misuse on secondary care by improving\ncare for alcohol misusing patients who present to hospitals. \n\nIt gives a return of investment (ROI) of £3.85 for every £1 invested, a year from implementation.","-","Primary PHE modelling","-","-","Effectiveness: a consultant-led, multi-disciplinary ACT in Bolton saved 2,000 alcohol related bed days and reduced readmissions by 3%. An external evaluation showed a 43% reduction (3,814 to 2,155) in alcohol-related A&E attendances alone, in the year following the introduction of a small alcohol care team in the Alexandra Hospital, Worcestershire. Costs: cost per nurse c£41,250 p.a., including on-costs. Depending on the size of the hospital, 3-5 specialist nurses would be needed to effectively deliver ACT. For example, to achieve this, Royal Bolton deployed a team of 4 alcohol specialist nurses providing a 7-day service costing c£165,000 p.a. Net savings: net savings per nurse can be c£111,930 p.a. on average, based on this case study which demonstrated net savings of £471,000 p.a. \n3.85 = (471+165)/165\nNICE endorsed study.","-","LA","LA / NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["G11","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Alcohol care teams","No","£1.86:£1","-","Cost-saving","A hospital-led alcohol assertive outreach service, which works with a cohort of the top 30 patients (frequent attenders) with the highest levels of alcohol-related admissions over a 6-month period. Each 6 months, this cohort is refreshed. The team also works proactively with any patient, who has had 2 alcohol-related admissions within a short period of time, the so-called ‘fast risers’.\n\nThe service generates a return of £1.86 for every £1.00 invested.","Cost-benefit analysis","Published NICE evidence","Frequent attenders / 'fast risers' in Salford. ","No intervention - standard care","Work with the first top 30 cohort resulted in a 59% reduction in emergency department attendances in the three-month period post-intervention, when compared with the three-month period before intervention (average monthly attendances were reduced from 120 to 49). There was also a 66% reduction in average monthly hospital admissions (50 to 17).\n\nAnnual service cost is £300,000, liberating two to three hospital beds and amounting to £556,500 in benefits. This does not take into account benefits from prevented admissions in the 'fast riser' population, since these cannot be measured. Other wider savings that would come from these alcohol interventions include improving the quality of life of the patients, reducing mortality and clinical accidents, as well as improved outpatient care, teaching and training.","3 months","LA","LA / NHS savings","England","-","£ GBP",2016,"Moriarty KJ. Alcohol Care Teams: reducing acute hospital admissions and improving quality of care. 2014. NICE Quality and Productivity: Proven Case Study. Provided by the British Society of Gastroenterology and Bolton NHS Foundation Trust.","Link to source","-","2017"]
["G12","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Identification and brief advice (IBA) in primary care settings","No","-","-","£27 pp. p.a.","IBA typically involves identification of a risky drinker (using a validated screening tool) and brief advice (short, structured advice to encourage a risky drinker to reduce their consumption).\n\nNet savings: PHE estimates that the net saving to the NHS per person receiving brief advice could be on average £27 p.a. (or equivalently a saving of £136 over 5 years).","-","Primary PHE modelling","-","-","Effectiveness: identification and brief advice (IBA) can reduce weekly drinking by between 13% and 34%, resulting in 2.9 to 8.7 fewer drinks per week. This will reduce relative risk of alcohol-related conditions by c14%, and absolute risk of lifetime alcohol related death by c20%. \nCosts: PHE estimates that the costs of IBA could be c£7.50 per person receiving brief advice. This would include the following components: £0.04 per person at consultation to complete an Audit-C scratch card; of the people completing the scratch card, we would expect c30% to screen above threshold, and their costs would also include at Local health and care planning: menu of preventative interventions 13 least £3.40 (1 min GP time) and £3.70 (5 min nurse time), when delivered in primary care. ","-","LA","LA / NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["G13","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Identification and brief advice (IBA) in primary care settings","No","-","Cost-effective","-","IBA typically involves identification of a risky drinker (using a validated screening tool) and brief advice (short, structured advice to encourage a risky drinker to reduce their consumption).\n\nA review of 23 studies reported strong evidence that IBA in primary healthcare is a cost-effective option for reducing alcohol misuse.","-","-","-","-","There was significant heterogeneity in methods and outcome measures between studies; however, almost all studies reported IBA programs to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result.","-","LA","QALY gains for service users, wider societal benefits (reduced crime, public nuisance, increased productivity)","High Income Countries","-","Various",2014,"Angus C, Latimer N, Preston L, Li J, Purshouse R. What are the Implications for Policy Makers? A Systematic Review of the Cost-Effectiveness of Screening and Brief Interventions for Alcohol Misuse in Primary Care. Frontiers in Psychiatry. 2014;5(114).","Link to source","PHE alcohol evidence review","2017"]
["G14","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Identification and brief advice (IBA)","No","-","Not cost-effective","-","IBA typically involves identification of a risky drinker (using a validated screening tool) and brief advice (short, structured advice to encourage a risky drinker to reduce their consumption).\n\nWhile IBA in sexual health clinics was relatively inexpensive to deliver, costing less than £13 per participant, when other costs and QALY outcomes were taken into account, it did not appear to be a cost-effective use of resources.","-","Published academic journal","-","-","Over 800 participants aged 19 years or over were randomly allocated to either brief advice, or a leaflet condition, and average weekly alcohol consumption during the previous 90 days was measured at six months after randomisation. Levels of unprotected sex were also observed. Compared to the leaflet condition, the adjusted MD in alcohol consumption at six months for those in the IBA group was borderline significant at 2.3 units per week (0.03, 4.7). There were no differences in self-reported levels of unprotected sex, 53% and 59% in the IBA and leaflet group respectively. ","-","LA","QALY gains for service users","England","-","£ GBP",2014,"Crawford M, Sanatinia R, Barrett B, Byford S, Dean M, Green J, et al. The clinical and cost effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR). Health Technol Assess 2014;18(30)","Link to source","PHE alcohol evidence review","2017"]
["G15","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Brief interventions delivered in GP surgeries\nto reduce problem drinking","No","-",null,"Cost saving","Physician advice in general practice regarding problem drinking. Intervention involved receiving a booklet, a workbook\nof current health behaviour, a review of prevalence of problem drinking, a list of adverse effects of alcohol, a worksheet\non drinking cues, a drinking agreement (prescription and drinking diary cards) - intervention consisted of two 15 minute\nappointments a month apart. Patients received a follow-up call from a clinic nurse 2 weeks after each GP meeting. \n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","Adults attending routine general practice\nappointments and drinking above threshold\nlimits as a percentage of the population\naged 15 and above in England","No intervention - usual curricula","Cost: £105.08 per person.\nOutcomes: reduced average alcohol consumption by 40% after 12 months, which provided an additional 0.0233 QALYs and £123 cost savings (due to reduced probabilities of 18 diseases related to alcohol consumption). Benefits are assumed to occur 5 years or more after intervention.","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["G16","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Restricting alcohol availability","No","-","$550-$1,450","-","Restricting alcohol availability, for example through reduced access to retail outlets for specified periods of the week.\n\nIt has the potential to be very cost-effective if fully enforced – saving $550 to $1,450 for each year in good health restored (cost per DALY saved).","Cost-utility analysis","Published book","-","-","Assumes 80% coverage. \nRange for different regions, $624 presented as cost per DALY saved for European countries.","-","LA","DALYs averted for service users","Various","-","$ USD",2013,"Leppo K, Ollila E, Peña S, Wismar M, Cook S. eds. Health in all Policies: Seizing opportunities, implementing policies.","Link to original source not available.","Information on evidence from this source","2017"]
["G17","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Mass media campaign ('The Australia campaign')","No","$7.5-$20.6:$1","-","Cost-saving","Mass media campaigns for reducing drinking and driving and alcohol-involved crashes.\n\nCost benefits analyses were conducted for three sites of a campaigns. In all three sites evaluated, the estimated societal benefits substantially exceeded the costs of developing and airing the campaign messages, with CBRs of 7.5:1, 11.4:1 and 20.6:1.","Cost-benefit analysis","Published academic journal","-","-","(1) Victoria campaign: for first 23 months, the cost $403,174 per month for advertisement development, supporting media, media placement, and concept research.  Estimated savings from medical costs, productivity losses, pain and suffering, and property damage were $8,324,532 per month, with $3,214,096 of these savings accruing from saved healthcare costs (CBR of 20.6).\n\nEffectiveness: based on a systematic review the median decrease in alcohol-related crashes resulting from mass media campaigns was 13% (interquartile range: 6% to 14%). \n\nThe mass media campaigns reviewed were generally carefully planned, well executed, attained adequate audience exposure, and were implemented in conjunction with other ongoing prevention activities, such as high visibility enforcement.","-","LA","Healthcare savings, productivity gains, property damage, pain and suffering","Australia","-","$ AUD 1997",2004,"Elder RW, Shults RA, Sleet DA, Nichols JL, Thompson RS, Rajab W. Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes: A systematic review. American Journal of Preventive Medicine. 2004;27(1):57-65.","Link to source","-","2017"]
["G18","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Drink-driving enforcement (via breathalysing)","No","$2-$57:$1","-","-"," All showed that the economic benefits of the interventions were greater than the costs, with benefit-cost ratios ranging from 2:1 to 57:1. Costs included the costs of operation and management, the driver’s time and media advertising and publicity. Benefits included potential averted crash costs such as healthcare and ambulance costs, police and court expenditures, property damage and productivity losses, revenues generated by the programme such as, police fines and towing fees and the monetary value of averted deaths. \n\nNot all studies included the same components which in part explain the differences in estimates.\n","Cost-benefit analysis","Published academic journal","-","-","(1) Selective breath testing checkpoints: 156 checkpoints (4 hours each) per year in the US. Effectiveness: Assumed 15% reduction in alcohol-related crashes. Total benefits: $9.2 million. Annual costs: $1.6 million. CBR = $6:$1.\n\n(2)  Selective breath testing checkpoints: The program consisted of 18 checkpoints per community plus publicity campaigns and education programs in the US. Effectiveness: Net reductions in alcohol-related crash injuries and deaths ranged from 17.5% to 31.6%. Total benefits: $3.86 million, from societal savings realised through injuries and fatalities avoided. Costs: $164,552 (excl. publicity campaigns and education programs). CBR = $23:$1.\n\n(3) Random breath testing (RBT) checkpoints: Study conducted 3 years after state-wide RBT checkpoints introduced in Australia. Effectiveness: assumption that 75% of the reduction in fatal crashes, serious injuries, minor injuries, and tow-away crashes was attributable to the checkpoints. Costs: $4 million; Benefits: $228 million ($US 1997). CBR = $57:$1.\n\n(4) Random breath testing (RBT) checkpoints: RBT in the Netherlands. Effectiveness: 25% reduction in alcohol-related injury or property damage on weekend nights. Total benefits: $31.4 million. Costs: $15.6 million. CBR = $2:$1.","-","LA","Healthcare savings, police and court expenditures, property damage, productivity loss, monetary value of averted deaths.","Various","-","$ USD 1997",2002,"Shults RA, Elder RW, Sleet DA, Nichols JL, Alao MO, Carande-Kulis VG, et al. Reviews\nof evidence regarding interventions to reduce alcohol-impaired driving. Am J Prev Med.\n2001 Nov;21(4, Supplement 1):66–88.","https://www.ncbi.nlm.nih.gov/pubmed/11691562","-","2017"]
["G19","Alcohol Misuse","Preventing and reducing harm from alcohol misuse in adults","Drink-driving legislation and enforcement (via random breath-testing campaigns)","No","-","$859","-","Drink-driving legislation and enforcement (via random breath-testing campaigns) has a cost per DALY saved of $859 for European countries.","Cost-utility analysis","Published book","-","-","Range of cost per DALY saved presented ($859-$1,388). The figure presented is most representative of the UK population (i.e. low child and adult mortality).\n\nBased on 80% coverage of intervention.","40 years","-","-","-",3.5000000000000003E-2,"$ USD 2010",2015,"World Health Organization. Promoting Health, Preventing Disease The Economic Case: The Economic Case: OECD Publishing; 2015.","Link to source","-","2017"]
["H1","Drug Misuse","Structured treatment for drug dependence in adults","Structured drug treatment","No","£2.50:£1","-","-","Structured drug treatment comprises of inpatient drug treatment, specialist and\nGP prescribing, counselling, structured day programmes, residential rehabilitation, structured alcohol interventions and other structured interventions.\n\nEvery £1 spent on drugs treatment saves society around £2.50 in reduced NHS and social care costs and reduced crime. Almost 15 per cent of these savings are due to reductions in health and social care costs whereas 85 per cent are due to reductions in offending.","Cost-benefit analysis","Published report","Cohort study - 1,796 sample of adults broadly representative of the population of Tier 3 and Tier 4 treatment-seekers in England","No intervention","Overall, the net benefits of structured drug treatment were estimated to be positive, both overall and at the individual level in around 80% of cases. The results are broadly generalisable to the population of people seeking structured drug treatment in England and Wales.\nTotal Benefits = £11,831, of which  £1,686 (health and social care savings), £10,145 (savings in reported offences), 0.05 QALY gain.\nTotal Cost = £4,531\nNet saving = £7,425\nAnalysis presents an approximate CBR based on figures rather than exact CBR. ","3-5 months follow up","LA","Criminal justice system, NHS and LA, QALY gains for service user","England","-","£ GBP 2006/07",2009,"Davies L JA, Vamvakas G, Dubourg R, Donmall M. . The Drug Treatment Outcomes Research study (DTORS): Cost-effectiveness analysis (2nd edition). Home Office Research Report 25; 2009.","Link to source","Link to summary of paper","2017"]
["H2","Drug Misuse","Structured treatment for drug dependence in adults","Injectable opioid treatment","No","-","Injectable heroin more cost-effective than oral methadone","-","Injectable heroin and oral methadone are used as treatment for chronic heroin addiction. It is important to note that injectable heroin is only given to a small minority of deeply entrenched heroin users.\n\nAt a willingness to pay of £30 000, there is a 70% probability that injectable heroin is more cost-effective than oral methadone. \n\nInjectable opioid treatments are more cost-effective than optimised oral methadone for chronic refractory heroin addiction. The choice between supervised injectable heroin and injectable methadone is less clear. There is currently evidence to suggest superior effectiveness of injectable heroin but at a cost that policy makers may find unacceptable. ","-","Published academic journal","-","-","Intervention costs over 26 weeks were significantly higher for injectable heroin (mean £8995 v. £4674 injectable methadone and £2596 oral methadone; P<0.0001). Costs overall were highest for oral methadone (mean £15 805 v. £13 410 injectable heroin and £10 945 injectable methadone;) due to higher costs of criminal activity. In cost-effectiveness analysis, oral methadone was dominated by injectable heroin and injectable methadone (more expensive and less effective). At willingness to pay of £30 000 per QALY, there is a higher probability of injectable methadone being more cost-effective (80%) than injectable heroin.","-","-","-","-","-","£ GBP",2013,"Byford S, Barrett B, Metrebian N, Groshkova T, Cary M, Charles V, et al. Cost-effectiveness of injectable opioid treatment v. oral methadone for chronic heroin addiction. The British Journal of Psychiatry. 2013;203(5):341-9.","Link to source","-","2017"]
["H3","Drug Misuse","Structured treatment for drug dependence in adults","Opioid substitution therapy (OST)","No","-","£13,700-£26,400","-","OST is used as substitution therapy in opioid dependence.\n\nIt is likely that OST in general is cost‑effective, with certain forms of OST likely to be more cost‑effective than others. Comparing methadone with buprenorphine, NICE reports £13,700 per QALY for methadone and £26,400 per QALY gained for buprenorphine (NICE, 2007a). ","-","Published report","-","-","The recent launch of generic buprenorphine and the subsequent reduction in cost will have narrowed this difference.","-","-","-","England","-","£ GBP",2007,"Methadone and buprenorphine for the management of opioid dependence. NIC TA guidance 2007","Link to source","NICE guidance","2017"]
["H4","Drug Misuse","Structured treatment for drug dependence in adults","Diversion and aftercare programmes for offenders using Class A drugs","No","-","Possibly cost-effective","-","Programmes to identify and divert problematic drug users to treatment (voluntary, court mandated or monitored services) at any point within the criminal justice system (CJS). Aftercare follows diversion and treatment, excluding care following prison or non-diversionary drug treatment.\n\nFor many of the analyses, the likelihood that diversion is cost-effective, if decision-makers were willing to pay up to £30,000 to gain one additional QALY for arrested drug users, was between 48% and 52%.  These findings suggest that there is\na lack of evidence either way, which is supported by the use of multiple-way sensitivity analyses to reflect changes in more than one parameter at a time.","Cost-utility analysis","Published academic journal","-","Intervention (usual pathway)","No relevant studies were identified for the cost-effectiveness review. The main reason for exclusion of economic analyses was that they did not conduct a full economic evaluation that compared diversion to an alternative and included a measure of health benefit (effectiveness, QALY or monetary value of participant health and well-being) or estimated either an ICER or cost–benefit ratio.\nConclusions derived from the economic analysis were limited by the constraints of available data and uncertainty about structural aspects of the model. It remains unclear whether or not the UK model of diversion (DIP) had no impact compared with no diversion, or whether or not the evidence is insufficient to identify an existing difference.\n\nThere was a wide variance in net costs (net cost - £147; 95% percentiles = £17.573 to £16,317) and a small net gain in QALYs (net QALY 0.005)","1 year","-","-","England",3.5000000000000003E-2,"-",2015,"Hayhurst KP LM, Davies L, Flentje R, Millar T, Jones A, King C, Donmall M, Farrell M, Fazel S, Harris R, Hickman M, Lennox C, Mayet S, Senior J, Shaw J. The effectiveness and cost-effectiveness of diversion and aftercare programmes for offenders using class A drugs: a systematic review and economic evaluation. Health Technology Assessment 2015; No. 19.6.","Link to source","-","2017"]
["H5","Drug Misuse","Structured treatment for drug dependence in adults","Contingency management","No","-",11192,"-","Contingency management is the provision of incentives to clients; these are contingent on maintaining or avoiding specified behaviours, such as avoiding the use of illicit drugs.\n\nIt had a cost of £11,192 to gain 1 QALY over standard care.","Cost-utility analysis","Published NICE guidance","-","Standard care","£2,660 cost per person (comparator cost = £2,372), average QALY gain = 0.79 (incremental QALY gain over comparator, 0.77).","1 year","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"National Collaborating Centre for Mental Health. Drug misuse: psychosocial interventions. National Clinical Practice Guideline Number 51 National Institute for Health and Clinical Excellence 2008.","Link to source","Based on evidence from evaluations conducted by NICE (CG51)","2017"]
["H6","Drug Misuse","Structured treatment for drug dependence in adults","Cognitive behavioural therapy","No","-",31151,"-","Cognitive behavioural therapy (CBT) is a discrete, time limited, structured psychological intervention to identify and modify irrational thoughts, manage negative mood and intervene after a lapse to prevent a full blown relapse.\n\nIt had a cost of £31,151 per QALY for cannabis users, suggesting that it is not cost‑effective in this instance. However, as this is just over the standard NICE threshold, consideration of additional benefits outside of QALYs may mean that it is cost-effective.","Cost-utility analysis","Published NICE guidance","-","Standard care","£460.50 cost per person (comparator cost = £0), average QALY gain = 0.254 (incremental QALY gain over comparator, 0.015).","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"National Collaborating Centre for Mental Health. Drug misuse: psychosocial interventions. National Clinical Practice Guideline Number 51 National Institute for Health and Clinical Excellence 2008.","Link to source","Based on evidence from evaluations conducted by NICE (CG51)","2017"]
["H7","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Review prescriptions of medicines liable to dependence","No","-","-","c£182 p.a. per patient","Review consisted of GPs identifying patients with repeat prescription for medicines liable to dependence, requesting patients attend appointment to review prescription and make decision to continue / change / end prescription.\n\nReview reduced prescribing of Pregabalin by 29%. Savings accrued to the NHS from a lower number of prescriptions of Pregabalin or less expensive prescriptions.","Cost-benefit analysis","PHE primary modelling","Pilot site in Doncaster with 10 GP practices","No intervention","PHE is working with a pilot site in Doncaster with 10 GP practices. Each practice nominated an ATM champion who received relevant training and carried out additional patient appointments where necessary. The reviews focused on Pregabalin use in the GP practices and conducted audits of use in April and September 2015, comparing outcomes pre- and post-intervention. Collectively, the GP surgeries reduced prescribing of Pregabalin by 29% (ranging from - 88% to +5%). This represents an annualised gross saving from reduced prescribing costs of £120,000 compared to an investment of c£10,000.","6 months ","NHS","NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-","2017"]
["H8","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Needle and syringe programme","No","-","-","c£330 per injecting drug user","Needle and syringe programmes (NSPs) for people  who inject drugs aim is to reduce the transmission of viruses and other infections caused by sharing injecting equipment, such as HIV, hepatitis B and C.\n\nA 10% increase of people who inject drugs using NSPs amounts to a potential £31m return on investment, around £330 per injecting drug users.","Cost-benefit analysis","Published NICE guidance","-","-","Drug prevalence estimates suggest that there are 93,400 heroin and/or crack cocaine injectors in England. In 2012, there were 10,873 diagnoses of hepatitis C infection in England, of which 96% were injecting drug users (n=10,438). NICE assume that a 10% increase in people using NSPs amounts to a 10% decrease in the number of hepatitis C infections (10,438*10% = 1,044). The cost of treating hepatitis c is £22,000-£41,000. The midpoint of these is £31,500. The cost saving from 1,044 not being infected with hepatitis C is roughly £32,900,000. The cost saving minus the cost of NSP is £31,000,000.","-","LA","Reduced transmission of hepatitis C, NHS savings","England","-","£ GBP",2014,"National Institute for Health and Care Excellence. Costing statement: Needle and syringe programmes. Implementing the NICE guidance on Needle and syringe programmes (PH52). 2014.","Link to source","Based on evidence from evaluations conducted by NICE (PH52)","2017"]
["H9","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Needle and syringe programme","No","-","Dominant-£17,000","-","Needle and syringe programmes (NSPs) for people  who inject drugs aim is to reduce the transmission of viruses and other infections caused by sharing injecting equipment, such as HIV, hepatitis B and C.\n\nNSPs can act as referral point into treatment, and when these effects were modelled, it showed that a 13.5% per cent increase in the rate of referral to opioid substitution therapy (OST) resulted in a cost per QALYs of between dominant and £17,000, depending on prevalence.","Cost-utility analysis","Published NICE guidance","-","Base Case Analysis","High hepatitis C virus (HCV) prevalence (Bristol); low HCV  prevalence (Teesside).\nAnalysis takes societal perspective.\n\nBristol:\nBaseline: cost =£375.06m, QALYs = 10,998\nIntervention: cost = £368.58m, QALYs = 11,038, cost / QALY = dominant\n\nTeesside:\nBaseline: cost =£35.28m, QALYs = 10,563\nIntervention: cost = £36.10m, QALYs = 10,612, cost / QALY = £16,568","20 years","LA","QALY gains for service users, NHS, PSS, costs of crime","England",3.5000000000000003E-2,"£ GBP",2008,"Vickerman P, Miners A, Williams A. Assessing the cost-effectiveness of interventions linked to needle and syringe programmes for injecting drug users: An economic modelling report. 2008. Department of Public Health and Policy, London School of Hygiene and Tropical Medicine: London. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH18)","2017"]
["H10","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Needle and syringe programme","No","-","£12,300-£38,700","-","Needle and syringe programmes (NSPs) for people  who inject drugs aim is to reduce the transmission of viruses and other infections caused by sharing injecting equipment, such as HIV, hepatitis B and C.\n\nThe NICE guidelines model the cost‑effectiveness of expanding NSP provision to high syringe coverage (i.e. obtain more syringes than they inject per week). This modelled a range of different scenarios (a 12.5% and 25% increase in NSP coverage for a high and low incidence city) and found QALYs costs between £12,300 and £38,700.","Cost-utility analysis","Published NICE guidance","-","Base Case Analysis","High hepatitis C virus (HCV) prevalence (Bristol); low HCV  prevalence (Teesside).\nAnalysis takes societal perspective.\n\nBristol:\nBaseline: cost =£481.12m, QALYs = 10,563\nIntervention: cost = £481.25m, QALYs = 10,566-10,569, cost / QALY = £38,679\n\nTeesside:\nBaseline: cost =£375.06m, QALYs = 10,998\nIntervention: cost = £375.11m, QALYs = 11,000-11,002, cost / QALY = £12,285","20 years","LA","QALY gains for service users, NHS, PSS, costs of crime","England",3.5000000000000003E-2,"£ GBP 2007",2008,"Vickerman P, Miners A, Williams A. Assessing the cost-effectiveness of interventions linked to needle and syringe programmes for injecting drug users: An economic modelling report. 2008. Department of Public Health and Policy, London School of Hygiene and Tropical Medicine: London. 2012.","Link to source","Based on evidence from evaluations conducted by NICE (PH18)","2017"]
["H11","Drug Misuse","Specialist drugs misuse services for children and young people","Specialist Drug and Alcohol Services for Young People","No","£1.93:£1; £4.66-£8.38:£1","-","-","The intervention is defined as a care planned medical, psychosocial or specialist harm reduction intervention, aimed at preventing escalation of use or harm.\n\nThe in-year return on investment from youth services treatment is £1.93 for every £1 spent (£1.87 relates to reductions in offending, £0.06 relates to health benefits). \n\nIn the long-term this increases to £4.66-£8.38 return for every £1 spent. This includes: the in-year benefits; £1.95-£3.90 which relates to reducing the 'scar' on earning associated with poor education and employment outcomes; £0.78-£2.56 relates to halting the escalation of young people's substance misuse and preventing subsequent problems as adults.","Cost-benefit analysis","Published report","Sample of approximately 24,000 young people who received specialist treatment in the UK in 2008-09","No intervention","The report states that this is “…based on a conservative set of assumptions”, although this appears relatively high compared with the CBR identified for adult structured treatment by DTORS (see ID G12). This high CBR comes from the level of predicted long-term benefits, with the high level of uncertainty that comes about when predicting over a long timescale; when only the immediate benefits are considered, the ratio falls to 1.93:1 spent.\n\nS-T benefits average of 2 years; L-T 20 years.","2 years / 20 years","LA","LAs that provide  specialist drug and alcohol services for young people","England","0%; 3.5% ","£ GBP",2008,"Frontier Economics. Specialist drug and alcohol services for young people–a cost benefit analysis. Benefits. 2008:09.","Link to source","Based on evidence from evaluations conducted by NICE (PH18)","2017"]
["H12","Drug Misuse","Specialist drugs misuse services for children and young people","Peer mentoring","No","£16.42: £1","-","-","An economic evaluation based on a criminal justice orientated cost-benefit model identified that peer mentoring interventions targeting at-risk students including regular truants were estimated to be cost saving.","Cost-utility analysis","Published NICE guidance","-","-","Benefit cost ratio 16.42; total benefits $29,819, total costs $1,816).\nNot all peer mentoring interventions included within the cost-benefit model were targeted to a specific population. There was noted to be potentially serious to minor limitations with the model’s applicability outside a criminal justice perspective and uncertainty regarding methodology. There is further uncertainty about the applicability of the model to the UK, as it is based upon policy options available in Washington State, sources for costs and resources are from the United States, and all evaluations of intervention effectiveness included in the model were from the United States.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H13","Drug Misuse","Specialist drugs misuse services for children and young people","Multidimensional Treatment Foster Care","No","£2.11: £1","-","Cost-saving","An economic evaluation based on a criminal justice orientated cost-benefit model identified that an intervention targeting looked after children, Multidimensional Treatment Foster Care, was estimated to be cost saving. ","Cost-utility analysis","Published NICE guidance","-","-","Benefit cost ratio 2.11; total benefits $17,356, total costs $8,230.\n There were noted to be potentially serious to minor limitations with the model’s applicability outside a criminal justice perspective and uncertainty regarding methodology. There is further uncertainty about the applicability of the model to the UK, as it is based upon policy options available in Washington State, sources for costs and resources are from the United States, and all evaluations of intervention effectiveness included in the model were from the United States with the exception of one evaluation from Sweden.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H14","Drug Misuse","Specialist drugs misuse services for children and young people","Multicomponent interventions targeting at risk children","No","-","Not cost-effective","-","Economic evaluations based on a criminal justice orientated cost-benefit model identified that for two multicomponent interventions targeting at risk children, CASASTART, costs outweighed benefits. \n\nCASASTART targeted children in ‘high risk’ neighbourhoods including, but not exclusively, truants and school drop outs. Family Check-Up targeted children identified as being ‘at-risk’ by their teachers. ","Cost-utility analysis","Published NICE guidance","-","-","CASASTART (benefit cost ratio unavailable, total benefits -$4,979, total costs $7,038) \nFamily Check Up (benefit cost ratio 0.24; total benefits $77, total costs $328) costs outweighed benefits. There were noted to be potentially serious to minor limitations with the model’s applicability outside a criminal justice perspective and uncertainty regarding methodology. There is further uncertainty about the applicability of the model to the UK, as it is based upon policy options available in Washington State, sources for costs and resources are from the United States, and all evaluations of intervention effectiveness included in the model were from the United States.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H15","Drug Misuse","Specialist drugs misuse services for children and young people","Family based intervention (skills training for parents and case management) ","No","-","Not cost-effective","-","The model found that this intervention was unlikely to be cost effective at a willingness to pay threshold of £20,000 per QALY due to the restricted duration of benefits and high intervention costs.","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 1. \nAn economic model was built based on an experimental intervention with families of substance users by Catalano et al (1999) and a follow-up study by Haggerty et al (2008).\nThe economic and health benefits are limited to 12 months in the model as beyond 12 months of the study, each individual in the intervention or control cohorts had the same probability of using cannabis. The model found that this intervention was unlikely to be cost effective at a willingness to pay threshold of £20,000 per QALY due to the restricted duration\nof benefits and high intervention costs (£3,367) of ‘Focus on Families’ for one year. The ICER  in the base case scenario was around £99m per QALY gained. The intervention would have to cost less than £4 per person to be considered cost-effective, based on results being limited to 12 months.","1 year","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H16","Drug Misuse","Specialist drugs misuse services for children and young people","Brief, web-based\npersonalized feedback selective intervention for college student cannabis use. ","No","-",329000,"-","Brief, web-based\npersonalized feedback selective intervention for college student cannabis use. \n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £329,000 per QALY gained","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 2.\nSubgroup analysis found promising effects for those with a family history of drug problems and therefore supported selective targeting of the intervention which was applied in the model. Based on a cost of £15 the intervention would not be cost effective but if the intervention could be provided at a low cost of £1 or less then it would be dominant, i.e. less costly and more effective than a ‘do nothing’ alternative, as it provides resource savings and reductions in cannabis use. ","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H17","Drug Misuse","Specialist drugs misuse services for children and young people","Familias Unidas to reduce drug and alcohol use","No","-",241000,"-","Familias Unidas to reduce drug use (in particular, cannabis) and alcohol use is most effective for adolescents with parents exhibiting high stress and lower levels of social support. It includes eight 2-hour multi-parent group sessions and four 1-hour family visits. \n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £241,000 per QALY gained.","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 3.\nAn economic model was informed by Prado et al (2012) based on an intervention called Familias Unidas to reduce drug use (in particular, cannabis) and alcohol use. Familias Unidas is most effective for adolescents with parents exhibiting high stress and lower levels of social support. Familias Unidas includes eight 2-hour multi-parent group sessions and four 1-hour family visits. The model found that this intervention was unlikely to be cost effective at a willingness to pay threshold of £20,000 per QALY due to restricted benefits of the intervention and the costs of delivery (£154.25 per family).  The intervention would have to cost less than £135 and the effects extrapolated to an additional 12 months to be considered cost-effective.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H18","Drug Misuse","Specialist drugs misuse services for children and young people","Motivational interviewing to reduce ecstasy use in those attending nightclubs","No","-",485000,"-","Motivational interviewing to reduce ecstasy use in those attending nightclubs.\n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £485,000 per QALY gained. ","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 4\nAn economic model based on a study of motivational interviewing to reduce ecstasy use in those attending nightclubs, based on Martin et al. 2010, found that the intervention was not likely to be cost effective at a willingness to pay threshold of £20,000 per QALY gained. Even if the effect of reducing drug use was maintained for at least two years, the cost halved to £32 and a discount rate of 1.5% applied, the ICER was still £70,000. In fact, the intervention could only be cost effective if delivered at a cost of £4.20 per hour or less in the base case scenario.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H19","Drug Misuse","Specialist drugs misuse services for children and young people","Motivational interviewing to reduce drug use in young gay and bisexual men","No","-",301000,"-","Motivational interviewing to reduce drug use in young gay and bisexual men.\n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £301,000 per QALY gained. ","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 5\n An economic model based on a study of motivational interviewing to reduce drug use in young gay and bisexual men, based on Parsons et al., (2014) found that the intervention was not likely to be cost effective at a willingness to pay threshold of £20,000 per QALY gained. This intervention would only be cost effective if the effect of reducing drug use was maintained for at least two years, and if the intervention could be provided at a cost of less than £88.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H20","Drug Misuse","Specialist drugs misuse services for children and young people","Motivational interviewing intervention to reduce club drug use and HIV risk behaviours among men who have sex with men ","No","-",131000,"-","Motivational interviewing intervention to reduce club drug use and HIV risk behaviours among men who have sex with men.\n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £131,000 per QALY gained. ","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 6 \nAn economic model based on a study of a motivational interviewing intervention to reduce club drug use and HIV risk behaviours among men who have sex with men by Morgenstern et al. (2009) found that the intervention was not likely to be cost effective at a willingness to pay threshold of £20,000 per QALY gained. This intervention would only be cost effective if the effect of reducing drug use was maintained for at least two years, and if the intervention could be provided at a cost of less than £190. The intervention was targeted to men with an average age of 38 but if it could be provided to younger men then it would be more likely to be cost effective as younger people are more likely to become drug dependent and to lose more years of life through early death associated with drug use.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H21","Drug Misuse","Specialist drugs misuse services for children and young people","Family Intervention STRIVE (Support to Reunite, Involve and Value Each Other)","No","-",117000,"-","Family Intervention STRIVE (Support to Reunite, Involve and Value Each Other).\n\nThe ICER (incremental cost effectiveness ratio) in the base case scenario was around £117,000 per QALY gained.","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 7\nAn economic model based on a study of a family intervention called STRIVE (Support to Reunite, Involve and Value Each Other) by Milburn et al (2012) found that this intervention was not likely to be cost effective at a willingness to pay threshold of £20,000 per QALY.  If the intervention cost was less than £500, and the intervention had a longer term effect over two years or more, then it would be cost effective.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H22","Drug Misuse","Specialist drugs misuse services for children and young people","Drug use prevention interventions","No","-","Not cost-effective","-","The results of the economic modelling suggest that, to be cost effective, drug use prevention interventions would need to cost less than £100 per person, and would need to reduce drug use by at least five percentage points, maintained over two years (for example to reduce drug use from 20% to 15% of a population). Targeting interventions at individuals who are at high risk of drug use or harmful consequences of drug use, or at individuals who are already drug users, would most likely make interventions more efficient. If interventions can prevent more harmful forms of drug use like opiate use then they will be more likely to be cost effective.","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 8 \n","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H23","Drug Misuse","Specialist drugs misuse services for children and young people","Drug use prevention interventions","No","-","-","-","If drug prevention interventions that are effective over a period of time can be provided as part of multicomponent interventions at an additional cost of less than around £100, then they may represent a cost effective component of these programmes.","Cost-utility analysis","Published NICE guidance","-","-","Health economic modelling statement 9 \n","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2017,"National Institute for Health and Care Excellence. Drug misuse prevention: targeted interventions (NG64). Evidence statements from evidence review 1, evidence review 2, cost effectiveness review and health economic modelling. 2017.","Link to source","Based on evidence from evaluations conducted by NICE (PH4), now NG64.","2017"]
["H24","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Supervised injection facilities","No","CAD $5.12: $1","-","-","The Vancouver SIF (supervised injection facility) prevents 35 new cases of HIV and prevents 2.87 deaths each year. The average value of the benefits are $5.25 million for HIV infections prevented and $2.31 million for deaths prevented resulting in an average total saving of $7.56 million. The cost of operating the site is $1.5 million which provides an average benefit-cost ratio of 5.12","Cost-Benefit and Cost-Effectiveness Analysis","Published Academic Journal","Injecting drug users population in Vancouver, Canada","No Intervention","Cost Assumptions: this is based on operational costs of $1.5 million of the SIF portion of Insite and has been taken from the Principal Investigator, who evaluated Insight on behalf of Health Canada. The SIF is in operation for 18 hours per day. \nThe number of HIV infections prevented was determined as an average of 4 different models which assumed that IDUs (Injecting Drug Users) at the SIF (Insite) share needles at a frequency of 0.3 (30%) of non-Insite IDUs. The number of HIV infections prevented is 35 and given the lifetime cost of treating a new HIV infection is $150,000 - this results in a saving of $5,250,000.","Lifetime","-","Benefit-Cost Ratio\nNumber of HIV infections and overdose deaths prevented. \nCost saved by prevention. \n","Canada",0.03,"$ CAD",2010,"Andresen MA, Boyd N. A cost-benefit and cost-effectiveness analysis of Vancouver’s\nsupervised injection facility. Int J Drug Policy 2010;21:70–6.","Link to source","-",2019]
["H25","Drug Misuse","Preventing and reducing harm from drug misuse in adults","Needle exchange","No","ROI AUD$ :1.3 - 5.5","-","ICER: AUD$416 to $8750 per QALY from ","The needle-syringe programme, by providing sterile needles/syringes, aims to reduce the rate of receptive syringe sharing (RSS) amongst injecting drug users (IDUs) in Australia, in order to prevent the transmission of HIV and the Hepatitis C Virus (HCV). The ICER ranges from $416 to $8750 per QALY, depending on the RSS from 25% to 50%. This intervention results in a return of AU$1.3 to AU$5.5 for every $1 invested.","Cost-benefit analysis","Published Academic Journal","IDU (Injecting Drug User) population of Australia","No Intervention","ROI = (Benefit - Cost)/Cost\nAll costs were estimated using $ AUD 2008 and inflated to $ AUD 2010 using the health consumer price index.\nThe benefits were determined as difference between the current NSP and the counterfactual scenario of no intervention. RSS prevalence is the only parameter that is different, and is assumed to be 25%-50% in the absence of NSP and is 15-17% with NSP.\nThe threshold  value of a QALY is $50,000.","Lifetime","-","ROI\nQALYs\nRSS Prevalence","Australia",0.03,"$ AUD",2012,"Kwon JA, Anderson J, Kerr CC, et al. Estimating the cost-effectiveness of needle\nsyringe programs in Australia. AIDS 2012;26:2201–10.","Link to Source","-",2019]
["I1","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation in hospital","No","-","-","c£119 per quitter","Offering very brief advice (VBA)  to all hospitalised patients, regardless of admitting diagnosis. \n\nCumulative minimum of c£119 per quitter over the first 5 years to NHS (excluding ERS investment). Cost savings assume costs are phased and excluding the ERS investment. The intervention can become net saving in year 5 after implementation. NB this is a conservative estimate.","Cost-effectiveness analysis","Primary PHE modelling","-","Patients without a referral.","Effectiveness: the quit rates among patients who want to quit and take up a referral are between 15% and 20% compared to 3% to 4% among those without a referral.\n\nCosts: PHE estimates total costs of the intervention to be more than c£690 per successful quitter. Of these, the NHS could incur a one-off c£190 per successful long-term\nquitter from delivery of nicotine replacement therapy and follow-up, and could face a potential one-off investment from setting up an electronic referral system (ERS) of c£11k and annual ERS maintenance costs of c£3.5k. Local authorities could incur £500 of costs per successful quitter, through commissioning local stop smoking services.","5 years","Mostly LA, some NHS","NHS savings, some social care savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","Link to published analysis","2017"]
["I2","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation - brief advice","No","-","-","Dominant ","Three minutes of a GPs\ntime, assessing current and past smoking behaviour, providing information on consequences of smoking, providing options for support, providing advice on stop smoking medications.\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 3%\nCost = £7,221; Incremental cost = -£12\nQALY gain = 11.91; Incremental QALY = 0.01 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I3","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine patch - pharmacy consultation","No","-","-","Dominant ","Nicotine replacement therapy (NRT) for five weeks, five pharmacist consultations. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 24%\nCost = £7,100; Incremental cost = -£122\nQALY gain = 12.1; Incremental QALY = 0.2 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I4","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine patch - pharmacy consultation + behavioural programme","No","-","-","Dominant ","Nicotine replacement therapy (NRT) for five weeks, five pharmacist, consultations, five behavioural clinic visits.\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 35%\nCost = £7,010; Incremental cost = -£222\nQALY gain = 12.2; Incremental QALY = 0.2 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I5","Smoking and Tobacco","Stop Smoking services and interventions","Brief advice plus self-help material","No","-","-","Dominant ","Four minutes of a GPs time, assessing current and past smoking behaviour, providing information on consequences of smoking, providing options for support, providing advice on stop smoking medications; self-help material.\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 4%\nCost = £7,206; Incremental cost = -£26\nQALY gain = 11.92; Incremental QALY = 0.02 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I6","Smoking and Tobacco","Stop Smoking services and interventions","Brief advice plus self-help material plus NRT plus specialist clinic","No","-","-","Dominant ","Four minutes of a GPs time, assessing current and past smoking behaviour, providing information on consequences of smoking, providing options for support, providing advice on stop smoking medications; self-help material; NRT; clinic costs. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 15%\nCost = £7,118; Incremental cost = -£115\nQALY gain = 12.02; Incremental QALY = 0.12 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I7","Smoking and Tobacco","Stop Smoking services and interventions","Less intensive counselling and bupropion","No","-","-","Dominant ","8 weeks of bupropion; self-help material; 5- 10 min scripted call. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 24%\nCost = £6,920; Incremental cost = -£312\nQALY gain = 12.10; Incremental QALY = 0.19 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I8","Smoking and Tobacco","Stop Smoking services and interventions","More intensive counselling and bupropion","No","-","-","Dominant ","8 weeks of bupropion; self-help material, five calls with smoking specialist. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model. As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 31%\nCost = £6,818; Incremental cost = -£414\nQALY gain = 12.17; Incremental QALY = 0.26 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I9","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine patch - group counselling","No","-","-","Dominant ","Nicotine replacement therapy (NRT) for five weeks, five group visits. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model. As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 21%\nCost = £7,037; Incremental cost = -£196\nQALY gain = 12.02; Incremental QALY = 0.17 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I10","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine patch - individual counselling","No","-","-","Dominant ","Nicotine replacement therapy (NRT) for five weeks, five clinic visits. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 16%\nCost = £7,076; Incremental cost = -£156\nQALY gain = 12.03; Incremental QALY = 0.12 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I11","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine patch - no counselling","No","-","-","Dominant ","Nicotine replacement therapy (NRT) for five weeks. \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 12%\nCost = £7,098; Incremental cost = -£132\nQALY gain = 11.99; Incremental QALY = 0.20 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I12","Smoking and Tobacco","Stop Smoking services and interventions","Brief intervention plus self-help","No","-",370,"-","5 minutes of a GP's time, assessing current and past smoking behaviour, providing information on consequences of smoking, providing options for support, providing advice on stop smoking medications, plus self-help material.\n\nThe cost / QALY is estimated at £370, based on 8 estimates ranging from £292-847.","Cost-utility analysis","Published NICE guidance","Models cohort of smokers, based upon ages of 30,\n40, 50 and 60 years (and split by gender).","Background quit rate (1%)","Cost = £12 per person (£10 GP time, £2 self-help material)\nEffectiveness rate = 2.7% (over and above control).","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"Parrott S, Godfrey C, Kind P. Cost-effectiveness of brief intervention and referral for smoking cessation.","Link to source","Based on evidence from evaluations conducted by NICE (PH1).","2017"]
["I13","Smoking and Tobacco","Stop Smoking services and interventions","Brief intervention (5 minutes)","No","-",732,"-","5 minutes of a GP's time, assessing current and past smoking behaviour, providing information on consequences of smoking, providing options for support, providing advice on stop smoking medications, plus self-help material.\n\nThe cost / QALY is estimated at £732, based on 8 estimates ranging from £577-1,677.","Cost-utility analysis","Published NICE guidance","Models cohort of smokers, based upon ages of 30,\n40, 50 and 60 years (and split by gender).","Background quit rate (1%)","Cost = £10 per person (£10 GP time)\nEffectiveness rate = 1.7% (over and above control).","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"Parrott S, Godfrey C, Kind P. Cost-effectiveness of brief intervention and referral for smoking cessation.","Link to source","Based on evidence from evaluations conducted by NICE (PH1).","2017"]
["I14","Smoking and Tobacco","Stop Smoking services and interventions","Brief advice plus self-help material plus NRT","No","-",984,"-","Seven minutes of a GPs time; self-help material; nicotine replacement therapy (NRT). \n\nThe cost per QALY is estimated at £984. ","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 smokers, representative of adults 16+ population","Background quit rate (2%)","The lifetime costs include all medical costs that are incorporated in the model, based on 5 comorbidities (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, heart attack, stroke) As such, they include not only the cost of the intervention, but other costs such as treatment and comorbidities. Therefore, the cost of 'no intervention' is quite substantial, since rates of complications are likely to be high. The results refer to the 'average' smoker included in the model. The results are, therefore, a weighted average cost and QALY for each patient in the 1,000 cohort. \n\nQuit rate = 6%\nCost = £7,268; Incremental cost = £36\nQALY gain = 11.94; Incremental QALY = 0.04 QALY","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2007,"Flack SA, Taylor M, Trueman P. Cost-effectiveness of interventions for smoking cessation. York Health Economics Consortium. 2007.","Link to source","Based on evidence from evaluations conducted by NICE (PH10).","2017"]
["I15","Smoking and Tobacco","Stop Smoking services and interventions","Brief intervention (5 minutes plus NRT)","No","-",2110,"-","5 minutes of a GP's time. The addition of nicotine replacement therapy (NRT) to the brief intervention assumes 5 minutes of brief advice and advice to use NRT, following which 50% of patients will use a full NRT course and 50% will use NRT for one month.\n\nThe cost per QALY is estimated at £2,110, based on 8 estimates ranging from £1,664-£4,833.","Cost-utility analysis","Published NICE guidance","Models cohort of smokers, based upon ages of 30,\n40, 50 and 60 years (and split by gender).","Background quit rate (1%)","Cost = £82.56 (5 minutes GP time + NRT, assuming 50% use full NRT course and 50% use one months supply).\nEffectiveness rate = 3% (over and above control).\n","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2006,"Parrott S, Godfrey C, Kind P. Cost-effectiveness of brief intervention and referral for smoking cessation.","Link to source","Based on evidence from evaluations conducted by NICE (PH1).","2017"]
["I16","Smoking and Tobacco","Stop Smoking services and interventions","Nicotine replacement therapy","No","-","-",-2169,"Five minutes of GP opportunistic advice to smokers presenting at GP surgeries.\n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","Adult smokers visiting a GP as a\npercentage of the population ","No intervention - no provision / usual care","Cost: £11 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\n\nOutcomes: 0.727% increase in quit rate, producing 0.009 QALYs per person, £31.10 cost savings per person. Benefits accrue as a result of reduced probabilities of five diseases associated with smoking - lung cancer, stroke, coronary heart disease, heart attack and obstructive pulmonary disease. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["I17","Smoking and Tobacco","Stop Smoking services and interventions","Brief intervention delivered in GP practices","No","-","-",-933,"Nicotine replacement therapy comprises GP advice and prescriptions (baseline visit plus six prescriptions spread over\napproximately 12 weeks) and drug provision.\n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","Adult smokers who would like to quit","No intervention","Cost: £57.30 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\n\nOutcomes: 1.86% increase in quit rate, producing 0.024 QALYs per person, £79.70 cost savings per person. Benefits accrue as a result of reduced probabilities of five diseases associated with smoking - lung cancer, stroke, coronary heart disease, heart attack and obstructive pulmonary disease. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","-","2017"]
["I18","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: client centred","No","-",50,"-"," Improving uptake of smoking cessation interventions among the general population.\nThe cost / QALY is estimated at £50, based on 8 estimates ranging from £0-£437.","Cost-utility analysis","Published NICE guidance","-","Background quit rate; no intervention or usual care","Half of studies take place in UK settings. 6 out of 8 studies do not adjust for future relapse rate.\n\nThe estimates are based on a range of methods and costs. See p. 16 of the source for more details.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP 2007",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I19","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: drop-in/rolling community based","No","-",91,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost / QALY is estimated at £91.","Cost-utility analysis","Published NICE guidance","-","Background quit rate","1996 study. Cost = £22 pp., cost / QALY = £91","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I20","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation —general population: dentist based","No","-","Dominated to £360","-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is based on 3 estimates, ranging from dominated to £360.","Cost-utility analysis","Published NICE guidance","-","Usual care (query contamination)","Data on these interventions is taken from a review paper, there is insufficient detail on the interventions to explain this\nvariation.\n\n(1) 1999 study. Cost = £37 pp., cost / QALY = £360\n(2) 2002 study. Cost = £42 pp; cost / QALY = £269\n(3) 2005 non-UK study. Cost = £65 pp., cost / QALY = dominated.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I21","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: incentive schemes NRT","No","-","Dominated to £671; £1,627","-","Free NRT: The cost per QALY gained of free NRT is dominated  to £671 when targeted at the general population and £1,627 when targeted at disadvantaged groups. \n\nThe cost per QALY are based on 2 estimates (for general population and disadvantaged groups).","Cost-utility analysis","Published NICE guidance","-","Intervention - no NRT","(1) 2006 study. Non-UK based study. Cost = £108 pp., cost / QALY = £671\n(2) 2006 study. Non-UK based study. Cost = £6 pp., cost / QALY = £45\n(3) 2006 non-UK study. Cost = -£81 pp., cost / QALY = dominated.\n(3) 2006 study. UK based study. Cost = £230 pp., cost / QALY = £1,627","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I22","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: proactive telephone counselling","No","-","£144-£880","-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is based on 3 estimates ranging from £144-£880.","Cost-utility analysis","Published NICE guidance","-","Usual care or intervention but no telephone counselling","6 estimates have been excluded as they are greater than 25 years old.\n(1) 1996 study. Cost = £22 pp., cost / QALY = £880\n(2) 1996 study. Cost = £37pp., cost / QALY = £427\n(3) 1996 study. Cost = £45 pp., cost / QALY = £144","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I23","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: identify smokers through other means","No","-","Dominated to £4,178","-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is based on 4 estimates ranging from dominated to £4,178.","Cost-utility analysis","Published NICE guidance","-","No intervention","All reviews from non-UK based studies. \n(1) 2006 study. Cost = £1 pp., cost / QALY = £365\n(2) 2003 study. Cost = £17 pp., cost / QALY = £78\n(3) 2001 study. Cost = £36 pp., cost / QALY = £644\n(4) 2007 study. Cost =£ 41 pp., cost / QALY = £4,178\n(5) 2006 non-UK study. Cost = £6 pp., cost / QALY = dominated.","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I24","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—general population: pharmacist based","No","-","£546; £1,030","-"," Improving uptake of smoking cessation interventions among the general population. Pharmacist-based interventions. The cost per QALY gained for pharmacist interventions is £438-£655 when targeted at the general population and £1,030 when targeted at disadvantaged groups. \n\nCost / QALY based on 2 estimates ranging from £438-£655.","Cost-utility analysis","Published NICE guidance","-","Usual care","(1) 1998 study. Cost = £23 pp., cost / QALY = £438\n(2) 2001 study. Cost = £121 pp., cost / QALY = £655","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I25","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—disadvantaged groups: workplace","No","-",1399,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £1,399.\n\n","Cost-utility analysis","Published NICE guidance","-","No intervention","2006 non-UK study. Cost = £52 pp., cost / QALY = £1,399","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I26","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—disadvantaged groups: client-centred social marketing","No","-",1564,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £1,564.","Cost-utility analysis","Published NICE guidance","-","No intervention","1997 non-UK study. Cost = £86 pp., cost / QALY = £1,564","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I27","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation—disadvantaged groups: BA pregnant women","No","-",1593,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £1,593.","Cost-utility analysis","Published NICE guidance","-","Usual care","2006 non-UK study. Cost = £211 pp., cost / QALY = £1,593","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I28","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-",4005,"-","Quitting smoking in pregnancy through cognitive behaviour strategies (changing maladaptive thinking patterns and the negative behaviours associated with them).\n\nThe intervention has an ICER of £4,005 per QALY.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: £155.68 (8 sessions at £19.46)\nEffectiveness (relative risk vs. control group): 95% \nQuit rate of control group = 9.7% (based on Cochrane review).\nIncremental cost = £126.32, incremental QALYs = 0.0315","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I29","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-",3033,"-","Quitting smoking in pregnancy through stages of change (model to help patients change behaviour).\n\nThe intervention has an ICER of £3,033 per QALY.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: £26 (3 nurse calls, 15 mins each at cost of nurse at £29.96 per hour, plus cost of self help material, £3.53).\nEffectiveness (relative risk vs. control group): 99% \nQuit rate of control group = 9.7% (based on Cochrane review).\nIncremental cost = £19.88, incremental QALYs = 0.0066","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I30","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-",1992,"-","Quitting smoking in pregnancy through feedback (no further information provided).\n\nThe intervention has an ICER of £1,992 per QALY.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: £142.31 (7 calls in month 1, monthly calls thereafter). Lasting 15 mins each, at cost of nurse at £29.95 per hour).\nEffectiveness (relative risk vs. control group): 92%\nIncremental cost = £96.90, incremental QALYs = 0.0486","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I31","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","-","Dominant","Quitting smoking in pregnancy through rewards (based on 'Quit to Win' campaign, quitting smoking for an established period of time, with rewards for success).\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: £52.83 (based on 'Quit to Win' campaign, costed at $78.57).\nEffectiveness (relative risk vs. control group): 76%\nIncremental cost = -£52.07, incremental QALYs = 0.1105","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I32","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-",2253,"-","Quitting smoking in pregnancy through pharmacotherapies (nicotine replacement therapy).\n\n\nThe intervention has an ICER of £2,253 per QALY.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: £100.43 (based on cost of nicotine replacement therapy)\nEffectiveness (relative risk vs. control group): 95%\nIncremental cost = £71.07, incremental QALYs = 0.0315","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I33","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","-","Dominant","'Other' interventions (no further information provided).\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers","No intervention (aggregate of controls)","Cost: TBC\nEffectiveness (relative risk vs. control group): 96%\nIncremental cost = £23.74, incremental QALYs = 0.0254","Lifetime","LA","QALY gains for service users, healthcare savings","England",3.5000000000000003E-2,"£ GBP",2009,"Taylor M. Economic analysis of interventions for smoking cessation aimed at pregnant women. Supplementary report York Health Economics Consortium. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH26).","2017"]
["I34","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-",3630,"Dominant","High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £3,630\n(2) Mother outcomes (lifetime): dominant\n(3) Mother and children outcomes (lifetime): dominant \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behavioural","Based on 1996 non-UK study.\n\n(1) Cost per person: £21; QALY gains per person: 0.004; incremental effects at 12 months: 10%; healthcare cost savings: £7; productivity savings: £352.\n\n(2) Cost per person: £21; QALY gains per person: 0.037; incremental effects at 12 months: 10%; healthcare cost savings: £44; productivity savings: £1,299.\n\n(3)  Cost per person: £20; QALY gains per person: 0.113; incremental effects at 12 months: 10%; healthcare cost savings: £83; productivity savings: £1,299.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I35","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","-","Dominant","High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): dominant\n(2) Mother outcomes (lifetime): dominant\n(3) Mother and children outcomes (lifetime): dominant \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behavioural","Based on 1997 non-UK study.\n\n(1) Cost per person: £4; QALY gains per person: 0.003; incremental effects at 12 months: 9%; healthcare cost savings: £5; productivity savings: £277.\n\n(2) Cost per person: £4; QALY gains per person: 0.031; incremental effects at 12 months: 9%; healthcare cost savings: £37; productivity savings: £1,092.\n\n(3)  Cost per person: £5; QALY gains per person: 0.085; incremental effects at 12 months: 9%; healthcare cost savings: £64; productivity savings: £1,092.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I36","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","£634-£15,683","Dominant","High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £15,683\n(2) Mother outcomes (lifetime): £634\n(3) Mother and children outcomes (lifetime): dominant \n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - usual care","Based on 2006 non-UK study.\n\n(1) Cost per person: £105; QALY gains per person: 0.006; incremental effects at 12 months: 16%; healthcare cost savings: £13; productivity savings: £563.\n\n(2) Cost per person: £105; QALY gains per person: 0.056; incremental effects at 12 months: 16%; healthcare cost savings: £69; productivity savings: £2,047.\n\n(3)  Cost per person: £105; QALY gains per person: 0.199; incremental effects at 12 months: 16%; healthcare cost savings: £143; productivity savings: £2,047.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I37","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","£3,874-£155,506","-","High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £155,506\n(2) Mother outcomes (lifetime): £15,281\n(3) Mother and children outcomes (lifetime): £3,874","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - usual care","Based on 2003 non-UK study.\n\n(1) Cost per person: £233; QALY gains per person: 0.001; incremental effects at 12 months: 4%; healthcare cost savings: £3; productivity savings: £150.\n\n(2) Cost per person: £233; QALY gains per person: 0.014; incremental effects at 12 months: 4%; healthcare cost savings: £17; productivity savings: £514.\n\n(3)  Cost per person: £233; QALY gains per person: 0.051; incremental effects at 12 months: 4%; healthcare cost savings: £36; productivity savings: £514.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I38","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","£412-£38,712","-","Conditional incentives provide vouchers conditional on smoking behaviour (non-conditional are incentives that do not depend on smoking behaviour).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £38,712\n(2) Mother outcomes (lifetime): £3,076\n(3) Mother and children outcomes (lifetime): £412","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - non-conditional incentives","Based on 2010 non-UK study.\n\n(1) Cost per person: £312; QALY gains per person: 0.008; incremental effects at 12 months: 21%; healthcare cost savings: £18; productivity savings: £806.\n\n(2) Cost per person: £312; QALY gains per person: 0.072; incremental effects at 12 months: 21%; healthcare cost savings: £90; productivity savings: £2,668.\n\n(3)  Cost per person: £312; QALY gains per person: 0.278; incremental effects at 12 months: 21%; healthcare cost savings: £198; productivity savings: £2,668.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I39","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","£788-£57,699","-","Conditional incentives provide vouchers conditional on smoking behaviour (non-conditional are incentives that do not depend on smoking behaviour).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £57,699\n(2) Mother outcomes (lifetime): £5,149\n(3) Mother and children outcomes (lifetime): £788","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - non-conditional incentives","Based on 2000 non-UK study.\n\n(1) Cost per person: £339; QALY gains per person: 0.006; incremental effects at 12 months: 15%; healthcare cost savings: £15; productivity savings: £640.\n\n(2) Cost per person: £339; QALY gains per person: 0.053; incremental effects at 12 months: 15%; healthcare cost savings: £68; productivity savings: £1,997.\n\n(3)  Cost per person: £339; QALY gains per person: 0.228; incremental effects at 12 months: 15%; healthcare cost savings: £159; productivity savings: £1,997.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I40","Smoking and Tobacco","Stop Smoking services and interventions","Quitting smoking in pregnancy","No","-","£388-£40,537","-","Conditional incentives provide vouchers conditional on smoking behaviour (non-conditional are incentives that do not depend on smoking behaviour).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Mother outcomes (3 years): £40,537\n(2) Mother outcomes (lifetime): £3,306\n(3) Mother and children outcomes (lifetime): £388","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - non-conditional incentives","Based on 2008 non-UK study.\n\n(1) Cost per person: £338; QALY gains per person: 0.008; incremental effects at 12 months: 21%; healthcare cost savings: £21; productivity savings: £877.\n\n(2) Cost per person: £338; QALY gains per person: 0.074; incremental effects at 12 months: 21%; healthcare cost savings: £94; productivity savings: £2,778.\n\n(3)  Cost per person: £338; QALY gains per person: 0.310; incremental effects at 12 months: 21%; healthcare cost savings: £218; productivity savings: £2,778.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I41","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in mental health services","No","-",11032,"Dominant"," Behavioural plus pharmacological for patients with PTSD. Behavioural interventions aim to change patient behaviour through counselling or therapy, plus anti-smoking medication (bupropion, varenicline, nicotine replacement).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Patients with PTSD (3 years): £11,032\n(2) Patients with PTSD (lifetime): dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - usual care","Based on 2005 non-UK study.\n\n(1) Cost per person: £94; QALY gains per person: 0.007; incremental effects at 12 months: 9%; healthcare cost savings: £13; productivity savings: £519.\n\n(2) Cost per person: £94; QALY gains per person: 0.100; incremental effects at 12 months: 9%; healthcare cost savings: £220; productivity savings: £1,538.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I42","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in mental health services","No","-","£6,407-£114,915","-"," Behavioural plus pharmacological for patients with PTSD. Behavioural interventions aim to change patient behaviour through counselling or therapy, plus anti-smoking medication (bupropion, varenicline, nicotine replacement).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Patients with PTSD (3 years): £114,915\n(2) Patients with PTSD (lifetime): £6,407","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - usual care","Based on 2010 non-UK study.\n\n(1) Cost per person: £421; QALY gains per person: 0.004; incremental effects at 12 months: 4%; healthcare cost savings: £6; productivity savings: £254.\n\n(2) Cost per person: £421; QALY gains per person: 0.049; incremental effects at 12 months: 4%; healthcare cost savings: £108; productivity savings: £752.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I43","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in mental health services","No","-","NA","-","Interventions delivered to patients with schizophrenia. \n(1) -(3) Behavioural plus pharmacological\n(4) High intensity behavioural vs. brief advice\n\nNo ICERs were estimated as the intervention showed no impact after 12 months.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Various","Based on 4 non-UK studies.\n\n(1) 2002 study. Cost per person: £65; QALY gains per person: 0; incremental effects at 12 months: 0%; healthcare cost savings: £30; productivity savings: £380.\n\n(2) 2008 study. Cost per person: £214; QALY gains per person: 0; incremental effects at 12 months: 0%; healthcare cost savings: £46; productivity savings: £588.\n\n(3) 2007 study. Cost per person: £124; QALY gains per person: 0; incremental effects at 12 months: 0%; healthcare cost savings: £124; productivity savings: £518.\n\n(3) 2004 study. Cost per person: £119; QALY gains per person: 0; incremental effects at 12 months: 0%; healthcare cost savings: £25; productivity savings: £311.\n","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I44","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-","-","Dominant","High intensity behavioural plus pharmacological delivered to preoperative patients. \n\n'High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks, plus anti-smoking medication (bupropion, varenicline, nicotine replacement).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Preoperative patients (3 years): Dominant\n(2) Preoperative patients (lifetime): Dominant\n\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behavioural","Based on 2002 non-UK study.\n\n(1) Cost per person: £97; QALY gains per person: 0.024; incremental effects at 12 months: 19%; healthcare cost savings: £273; productivity savings: £1,318.\n\n(2) Cost per person: £97; QALY gains per person: 0.222; incremental effects at 12 months: 19%; healthcare cost savings: £716; productivity savings: £716.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I45","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-","-","Dominant","High intensity behavioural plus pharmacological delivered to preoperative patients. \n\n'High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks, plus anti-smoking medication (bupropion, varenicline, nicotine replacement).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Preoperative patients (3 years): Dominant\n(2) Preoperative patients (lifetime): Dominant\n\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behavioural","Based on 2008 non-UK study.\n\n(1) Cost per person: £114; QALY gains per person: 0.028; incremental effects at 12 months: 22%; healthcare cost savings: £317; productivity savings: £1,503.\n\n(2) Cost per person: £114; QALY gains per person: 0.250; incremental effects at 12 months: 22%; healthcare cost savings: £815; productivity savings: £3,950.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I46","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-",8973,"Dominant","High intensity behavioural plus pharmacological delivered to patients with chronic obstructive pulmonary disease (COPD). \n\n'High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks, plus anti-smoking medication (bupropion, varenicline, nicotine replacement).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Patients with COPD (3 years): £8,973\n(2) Patients with COPD (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - brief advice","Based on 2006 non-UK study.\n\n(1) Cost per person: £182; QALY gains per person: 0.011; incremental effects at 12 months: 9%; healthcare cost savings: £87; productivity savings: £278.\n\n(2) Cost per person: £182; QALY gains per person: 0.012; incremental effects at 12 months: 9%; healthcare cost savings: £357; productivity savings: £278.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I47","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-",6592,"Dominant","Pharmacological intervention delivered to patients with chronic obstructive pulmonary disease (COPD). \n\n'Pharmacological interventions use anti-smoking medication (bupropion, varenicline, nicotine replacement) to change patient behaviour.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Patients with COPD (3 years): £6,592\n(2) Patients with COPD (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - usual care","Based on 2008 non-UK study.\n\n(1) Cost per person: £291; QALY gains per person: 0.020; incremental effects at 12 months: 17%; healthcare cost savings: £161; productivity savings: £517.\n\n(2) Cost per person: £291; QALY gains per person: 0.209; incremental effects at 12 months: 17%; healthcare cost savings: £665; productivity savings: £517.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I48","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-","-","Dominant","High intensity behavioural delivered to cardiac patients. \n\n'High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Cardiac patients (3 years): Dominant\n(2) Cardiac patients (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behavioural","Based on 2003 non-UK study.\n\n(1) Cost per person: £76; QALY gains per person: 0.011; incremental effects at 12 months: 20%; healthcare cost savings: £2,680; productivity savings: £1,125.\n\n(2) Cost per person: £76; QALY gains per person: 0.401; incremental effects at 12 months: 20%; healthcare cost savings: £15,792; productivity savings: £1,928.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I49","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-","-","Dominant","High intensity behavioural delivered to cardiac patients. \n\n'High intensity behavioural aims to change patient behaviour through counselling or therapy, with extensive contact with staff and supplementary material to help quit, and were followed up for at least 4 weeks.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Cardiac patients (3 years): Dominant\n(2) Cardiac patients (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - brief advice","Based on 2010 non-UK study.\n\n(1) Cost per person: £306; QALY gains per person: 0.0065; incremental effects at 12 months: 11%; healthcare cost savings: £523; productivity savings: £646.\n\n(2) Cost per person: £306; QALY gains per person: 0.230; incremental effects at 12 months: 11%; healthcare cost savings: £6,746; productivity savings: £1,107.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I50","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-",22362,"Dominant","'Pharmacological intervention delivered to general patients. \n\n'Pharmacological interventions use anti-smoking medication (bupropion, varenicline, nicotine replacement) to change patient behaviour.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) General patients (3 years): £22,362\n(2) General patients (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - low intensity behaviour","Based on 1997 non-UK study.\n\n(1) Cost per person: £138; QALY gains per person: 0.006; incremental effects at 12 months: 7%; healthcare cost savings: £10; productivity savings: £404.\n\n(2) Cost per person: £138; QALY gains per person: 0.078; incremental effects at 12 months: 7%; healthcare cost savings: £171; productivity savings: £1,197.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I51","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-",4273,"Dominant","'Pharmacological intervention plus low intensity behaviour delivered to hospital employees.\n\nBehavioural interventions aim to change patient behaviour through counselling or therapy, plus anti-smoking medication (bupropion, varenicline, nicotine replacement) to change patient behaviour.\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) General patients (3 years): £4,273\n(2) General patients (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - placebo plus low intensity behaviour","Based on 2004 non-UK study.\n\n(1) Cost per person: £41; QALY gains per person: 0.007; incremental effects at 12 months: 8%; healthcare cost savings: £12; productivity savings: £692.\n\n(2) Cost per person: £41; QALY gains per person: 0.093; incremental effects at 12 months: 8%; healthcare cost savings: £205; productivity savings: £2,051.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I52","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation delivered in acute services","No","-","-","Dominant","Total smoke free policy (smoking ban across hospital campus).\n\nThe intervention has an ICER (incremental cost - healthcare savings / incremental QALYs) of:\n(1) Hospital employees (3 years): £4,273\n(2) Hospital employees (lifetime): Dominant\n\nDominant - intervention is less costly and more effective than comparator.","Cost-utility analysis","Published NICE guidance","Hypothetical cohort of 1,000 pregnant smokers (age at which individuals enter model varied depending on target population)","Intervention - indoor smoke free policy","Based on 2010 non-UK study.\n\n(1) Cost per person: £22; QALY gains per person: 0.026; incremental effects at 12 months: 32%; healthcare cost savings: £45; productivity savings: £2,637.\n\n(2) Cost per person: £22; QALY gains per person: 0.355; incremental effects at 12 months: 32%; healthcare cost savings: £782; productivity savings: £7,814.\n\nShort-term productivity savings (due to reduced absenteeism and time spent smoking during working hours) are presented, but not included in ICER results as they were estimated to be dominant for all results.","3 years / lifetime","LA","QALY gains for service users, healthcare savings, productivity gains","England",3.5000000000000003E-2,"£ GBP 2011",2013,"Mallender J, Bertranou E, Bacelar M. Economic analysis of smoking cessation in secondary care: NICE public health guidance PH48. National Institute for Health and Care Excellence, ed. London: Matrix Knowledge. 2013.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I53","Smoking and Tobacco","Wider tobacco control","Tobacco control services","No","£11.20:£1","-","-","Over a lifetime, for every £1 spent in tobacco control services, the return will be £11.20  when impacts to the local economy, wider healthcare sector and QALYs are considered, equalling a net present value per smoker of £499.34.\n\nThe net present value is 1.9 when excluding QALYs (CBR = 1.9).","Cost-effectiveness analysis","-","-","No intervention","Based on NICE ROI tool for tobacco control. Illustrative results for Sunderland are presented. \n\nBenefits include productivity losses, treatment costs and the value of health gains.\n\nThe ROI is much lower when a shorter timeframe is considered. Over 2 years, there is a return of £0.90 for every £1 spent; over 5 years, there is a return of £2.10 for every £1 spent.","Lifetime","LA","Productivity losses; NHS treatment costs; QALY gain for service users.","England",3.5000000000000003E-2,"£ GBP",2014,"Pokhrel S, Owen L, Lester-George A, Coyle K, Coyle D, West R, Trapero-Bertran M, Meads C. 2014. Tobacco and Control Return on Investment Tool v3. London: National Institute for Health and Care Excellence.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I54","Smoking and Tobacco","Wider tobacco control","Mass-media intervention","No","-","-",-3032,"Adult anti-smoking one-year campaign comprising: (a) mass media advertising including television, outdoor posters,\nand press; (b) a free telephone helpline; and (c) a specially devised booklet providing practical advice on giving up\nsmoking and staying a non-smoker.\n\nNegative cost / QALY implies the intervention is cost saving.","Cost-utility analysis","Published report","Ratio of percentage of adult smokers in\nroutine and manual occupations","No intervention","Cost: £1.63 per person. Cost associated with increased life expectancy resulting from the intervention –such as pensions and health care costs– are not included in the analysis.\nOutcomes: 0.44% increase in quit rate, producing 0.006 QALYs per person, £18.90 cost savings per person. Benefits accrue as a result of reduced probabilities of five diseases associated with smoking - lung cancer, stroke, coronary heart disease, heart attack and obstructive pulmonary disease. QALY gain and cost savings are estimated to occur in the long-run (5 years or more after the intervention).","-","LA","QALY gains for service users, NHS savings","England",3.5000000000000003E-2,"£ GBP 2007/08",2009,"Matrix Insight. Prioritising investments in preventative health. Health England. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH48).","2017"]
["I55","Smoking and Tobacco","Wider tobacco control","Mass-media intervention","No","-",49,"-","Mass-media campaign to prevent the uptake of smoking by children and young people is estimated to have a cost / QALY of £49.","Cost-utility analysis","Published NICE guidance","Cohort simulation model ","Background quit rate (2%)","The model estimates the reduction in smoking prevalence achieved at the end of the intervention (aged 13-17 years). The model assumes this impact is maintained throughout adult life. QALY gains from  five diseases associated with smoking - lung cancer, stroke, coronary heart disease, heart attack and obstructive pulmonary disease.\n\nCost: £15 per person per year.\n5% effectiveness rate (incremental effect compared to comparator is 10 additional smokers quitting per 1,000).","5 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"Raikou M, McGuire A. Cost-effectiveness of a mass media campaign and a point of sale intervention to prevent the uptake of smoking in children and young people: economic modelling report. LSE Health. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH14).","2017"]
["I56","Smoking and Tobacco","Wider tobacco control","Point-of-sale intervention","No","-",1690,"-","Preventing the uptake of smoking by children and young people.\n\nThe cost per QALY is estimated at £1,690.","Cost-utility analysis","Published NICE guidance","Cohort simulation model ","Background quit rate (2%)","The model estimates the reduction in smoking prevalence achieved at the end of the intervention (aged 13-17 years). The model assumes this impact is maintained throughout adult life. QALY gains from  five diseases associated with smoking - lung cancer, stroke, coronary heart disease, heart attack and obstructive pulmonary disease.\n\nCost: £17 per person per year.\n0.5% effectiveness rate (incremental effect compared to comparator is 1 additional smoker quitting per 1,000).","5 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"Raikou M, McGuire A. Cost-effectiveness of a mass media campaign and a point of sale intervention to prevent the uptake of smoking in children and young people: economic modelling report. LSE Health. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH14).","2017"]
["I57","Smoking and Tobacco","Wider tobacco control","Smoking cessation—disadvantaged groups: recruitment at paediatric unit","No","-",1837,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £1,837.","Cost-utility analysis","Published NICE guidance","-","Usual care","2003 non-UK study. Cost = £155 pp., cost / QALY = £1,837","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I58","Smoking and Tobacco","Wider tobacco control","Smoking cessation—general population: incentive schemes workplace","No","-",2089,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £2,089.","Cost-utility analysis","Published NICE guidance","-","WI with no incentive","2002 non-UK study. Cost = £157 pp., cost / QALY = £2,089","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I59","Smoking and Tobacco","Wider tobacco control","Smoking cessation—disadvantaged groups: NHS SSS","No","-",2686,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £2,686, based on 2 estimates ranging from £2,535-£2,837.","Cost-utility analysis","Published NICE guidance","-","No intervention","(1) 2003 UK study. Cost = £196 pp., cost / QALY = £2,535\n(2)  2004 UK study. Cost = £196, cost / QALY = £2,837","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I60","Smoking and Tobacco","Wider tobacco control","Smoking cessation—disadvantaged groups: pharmacist based","No","-",3151,"-"," Improving uptake of smoking cessation interventions among the general population.\n\nThe cost per QALY is estimated at £3,151, based on 2 estimates ranging from £1,030-£5,272.","Cost-utility analysis","Published NICE guidance","-","No intervention","(1) 2002 non-UK study. Cost = £310 pp., cost / QALY = £5,272\n(2) 2006 UK study. Cost = £151 pp., cost / QALY = £1,030","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I61","Smoking and Tobacco","Wider tobacco control","Smoking cessation—disadvantaged groups: proactive telephone support pregnant women","No","-",5992,"-","Identifying and supporting people most at risk of dying prematurely.\n\nThe cost per QALY is estimated at £5,992.","Cost-utility analysis","Published NICE guidance","-","Intervention but no offer of telephone support","2000 non-UK study. Cost = £140 pp., cost / QALY = £5,992","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"National Institute for Health and Clinical Excellence. Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15). Supplementary economic analysis on interventions to reduce health inequalities. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH15).","2017"]
["I62","Smoking and Tobacco","Wider tobacco control","School based intervention - Curricular","No","-",7200,"-","School-based interventions to prevent the uptake of smoking.\n\nThe cost per QALY is estimated at £7,200, based on 4 estimates ranging from £2,030–£12,700.","Cost-utility analysis","Published NICE guidance","-","No intervention or standard education","Range of cost / QALY estimates presented, based on different effect models.\n(1) Cost = £38.50, extra medical cost = £0.82, discounted QALY gain per student = 0.00349, threshold cost per student = £69, cost / QALY = £11,300\n(2) Cost = £38.50, extra medical cost = £5.31, discounted QALY gain per student = 0.0216, threshold cost per student = £427, cost / QALY = £2,030\n(3) Cost = £38.50, extra medical cost = £0.72, discounted QALY gain per student = 0.0031, threshold cost per student = £61, cost / QALY = £12,700\n(4) Cost = £38.50, extra medical cost = £3.29, discounted QALY gain per student = 0.0135, threshold cost per student = £711, cost / QALY = £3,100","-","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2009,"Jit M, Barton P, Chen Y, Uthman O, Aveyard P, Meads C. School-based interventions to prevent the uptake of smoking among children and young people: Cost-effectiveness model. Birmingham, UK: West Midlands Health Technology Assessment Collaboration. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH23).","2017"]
["I63","Smoking and Tobacco","Stop Smoking services and interventions","Reduce tobacco harm: Cutting down to quit (CDTQ) use of NCP + behavioural  support","No","-","Dominant-£1,588 ","-","Cohort model simulated the cost and QALY associated with interventions supporting smokers cutting down to quit (CDTQ.) Reduced harm model included CDTQ without support or with support including Nicotine containing patch (NCP)/ NCP substitute, 2 units of generic/professional behavioural support or in combination.\n\nICER estimated to be between Dominant and £1,588 per QALY.\n","Cost-effectiveness analysis","Published NICE guidance","Cohort simulation model of 1,000 smokers representative of a population of typical smokers","No intervention","(1) CDTQ + NCP + generic support; overall cost = £7,132, cost / QALY = £462\n(2) CDTQ + NCP + specialist support; overall cost = £7,294, cost / QALY =£1,588\n(3) CDTQ + NCP; overall cost = £7,111, cost / QALY = £377\n(4) CDTQ + generic support; overall cost = £6,947, cost / QALY = Dominant \n(5) CDTQ + specialist support; overall cost = £7,109, cost / QALY = £302\n(6) CDTQ; overall cost = £6,926, cost / QALY = Dominant \n(7) No intervention; overall cost = £7,066, cost / QALY = n/a","Lifetime","NHS","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2012,"National Institute for Health and Clinical Excellence. An economic evaluation of different interventions to promote tobacco harm reduction (PH45). 2012","Link to source","Based on evidence from evaluations conducted by NICE (PH45).","2017"]
["I64","Smoking and Tobacco","Stop Smoking services and interventions","Reduce tobacco harm: Abrupt quit - use of NCP + behavioural  support","No","-","£1,922-£5,006 ","-","• Cohort model simulated the cost and QALY associated with interventions supporting smokers quitting abruptly. Reduced harm model included quitting abruptly with support including Nicotine containing patch (NCP)/ NCP substitute, 2 units of generic/professional behavioural support or in combination.\nICER estimated to be between £1,922 and £5,006 per QALY.\n","Cost-effectiveness analysis","Published NICE guidance","Cohort simulation model of 1,000 smokers representative of a population of typical smokers","No intervention","(1) Abrupt + NCP substitute + generic support; overall cost = £7,384, cost / QALY = £1,922\n(2) Abrupt + NCP substitute + specialist support; overall cost = £7,546, cost / QALY =£2,900\n(3) Abrupt + NCP substitute; overall cost = £7,321, cost / QALY = £5,006\n(4) No intervention; overall cost = £7,066, cost / QALY = n/a\n","Lifetime","NHS","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2012,"National Institute for Health and Clinical Excellence. An economic evaluation of different interventions to promote tobacco harm reduction (PH45). 2012","Link to source","Based on evidence from evaluations conducted by NICE (PH45).","2017"]
["I65","Smoking and Tobacco","Stop Smoking services and interventions","Reduce tobacco harm: Temporary abstinence- use of NCP + behavioural  support","No","-","No Benefit-£5735","-","Cohort model simulated the cost and QALY associated with interventions supporting a temporary abstinence from smoking. Reduced harm model included temporary abstinence without support or with support including Nicotine containing patch (NCP)/ NCP substitute, 2 units of generic/professional behavioural support or in combination.\n\nICER estimated to be between No benefit and £5,735 per QALY.\n\n","Cost-effectiveness analysis","Published NICE guidance","Cohort simulation model of 1,000 smokers representative of a population of typical smokers","No intervention","(1) Temporary abstinence + NCP + generic support; overall cost = £7,139, cost / QALY = £531\n(2) Temporary abstinence + NCP + specialist support; overall cost = £7,301, cost / QALY = £1,708\n(3) Temporary abstinence + NCP; overall cost = £7,218, cost / QALY = £5,364\n(4) Temporary abstinence + generic support; overall cost = £7,081, cost / QALY = £478\n(5) Temporary abstinence + specialist support; overall cost = £7,243, cost / QALY = £5,735\n(6) Temporary abstinence; overall cost = £7,066, cost / QALY = No benefit \n(7) No intervention; overall cost = £7,066, cost / QALY = n/a\n","Lifetime","NHS","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2012,"National Institute for Health and Clinical Excellence. An economic evaluation of different interventions to promote tobacco harm reduction (PH45). 2012","Link to source","Based on evidence from evaluations conducted by NICE (PH45).","2017"]
["I66","Smoking and Tobacco","Stop Smoking services and interventions","Reduce tobacco harm: Reduce- use of NCP + behavioural  support","No","-","Dominant to £5,735","-","Cohort model simulated the cost and QALY associated with interventions supporting smokers reduce the amount they smoked. Reduced harm model included reduced smoking without support or with support including Nicotine containing patch (NCP)/ NCP substitute, 2 units of generic/professional behavioural support or in combination.\nICER estimated to be between Dominant and £5,735 per QALY.\n","Cost-effectiveness analysis","Published NICE guidance","Cohort simulation model of 1,000 smokers representative of a population of typical smokers","No intervention","(1) Reduce + NCP + generic support; overall cost = £7,139, cost / QALY = £531\n(2) Reduce + NCP + specialist support; overall cost = £7,301, cost / QALY = £1,708\n(3) Reduce + NCP; overall cost = £7,218, cost / QALY = £5,364\n(4) Reduce + generic support; overall cost = £7,081, cost / QALY = £478\n(5) Reduce + specialist support; overall cost = £7,243, cost / QALY = £5,735\n(6) Reduce; overall cost = £7,031, cost / QALY = Dominant \n(7) No intervention; overall cost = £7,066, cost / QALY = n/a","Lifetime","NHS","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2012,"National Institute for Health and Clinical Excellence. An economic evaluation of different interventions to promote tobacco harm reduction (PH45). 2012","Link to source","Based on evidence from evaluations conducted by NICE (PH45).","2017"]
["I67","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation interventions in pregnancy - MiQuit","No","£14 : £1","Dominant: - £939.53","-","Based on an Economics of Smoking in Pregnancy (ESIP) model, which estimates the life-time cost-effectiveness of smoking cessation interventions in pregnancy from an NHS and personal social services perspective. ESIP uses data from a pragmatic RCT that tested a smoking cessation intervention in pregnancy.\n\nParticipants were pregnant smokers who received standard\nNHS smoking cessation care with an intervention group\nadditionally receiving a 12-week programme of tailored\ntext messages","Cost-effectiveness","Modelling","Women were recruited at an average of 15 weeks gestation","Standard NHS smoking cessation care","QALY discount rate = 3.5%\nCosts discount rate = 3.5%\n\nReported ICER allows for uncertainty in the model outputs.\n\nICER includes QALY gains for the mother and baby","12 weeks intervention\n\n21 weeks of monitoring","NHS","Economic benefits\nMaternal outcomes\nOffspring outcomes","England and Wales",3.5000000000000003E-2,"£ GBP",2018,"Matthew J,  Murray S,  Sarah L,  Steve P,  Tim C - A dynamic, modifiable model for estimating cost-effectiveness of smoking cessation interventions in pregnancy: application to an RCT of self-help delivered by text message","Link to source","-",2019]
["I68","Smoking and Tobacco","Tobacco - incentives for cessation","Cessation in Pregnancy Incentives Trial (CPIT) Team","No","-",482,"-","Randomly allocated eligible women to either receive the offer of up to £400 of shopping vouchers (if they engaged with services and subsequently quit) in addition to routine specialist pregnancy stop smoking services or routine care. Health was a primary aim (RCT to assess the efficacy of a financial incentive added to routine specialist pregnancy stop smoking services versus routine care to help pregnant smokers quit). ","Cost-utility (based on RCT programme)","Modelling","Pregnant women (low socio-economic communities)","No intervention","QALYs to mother and child\n\nICER timeframe is over a lifetime","1 year","Local authorities (most cases)\n\nNHS (less cases e.g. hospital and prison)","Pregnancy outcomes\nQALYs\nSmoking cessation","Scotland","N/A","£ GBP",2011,"Tappin DM, Bauld L, Tannahill C, de Caestecker L, Radley A, McConnachie A, et al. The cessation in pregnancy incentives trial (CPIT): study protocol for a randomized controlled trial. Trials. 2012;13:113. \nTappin D, Bauld L, Purves D, Boyd K, Sinclair L, MacAskill S, et al. Financial incentives for smoking cessation in pregnancy: randomised controlled trial. BMJ. 2015;350:h134. \nTappin D, Bauld L, Purves D, Boyd K, Sinclair L, MacAskill S, et al. Financial incentives for smoking cessation during pregnancy: a randomised controlled trial. The Lancet. 2014;384:S4. Boyd KA, Briggs AH, Bauld L, Sinclair L, Tappin D. Are financial incentives cost-effective to support smoking cessation during pregnancy? Addiction. 2016;111(2):360-70 \nMcConnachie A, Haig C, Sinclair L, Bauld L, Tappin DM. Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis. Trials. 2017;18(1):337.\n","Link to source","-",2019]
["I69","Smoking and Tobacco","Stop Smoking services and interventions","Smoking cessation","No","£1.77 : £1","Current package is dominant over baseline scenario of doing nothing","Current package is dominant over baseline scenario of doing nothing","Running the NICE Tobacco Control ROI Tool v3.0 for the population of Wirral indicates that investing £1 on its current package of interventions for smoking cessation produces a BCR of 1.77 over a lifetime. Over a lifetime the current package costs less and provides more QALYs, averted deaths and life years gained compared to doing nothing.","Cost-Utility Analysis","NICE ROI Tool","Population of Wirral, UK","No intervention"," The BCR is based on a quasi-societal perspective which includes benefits and costs to the local economy and wider healthcare sector and over a lifetime horizon/timeframe. 9.6% of current smokers are allocated to an individual-level intervention and the current package requires an initial investment of £1,047,120.\n9.3% of smokers receive Local Stop Smoking Service intervention (costing £828,986), 32.6% of pregnant smokers receive behavioural support (costing £28,346) and 26.0% of non-pregnant smokers are given GP Brief advice (£189,789). ","Lifetime","LA","QALYs gained per 1,000 population. Smoking-related death averted. Life years gained. \nBenefit-Cost Ratio\nICER","England",3.5000000000000003E-2,"£ GBP",2015,"Collins B. Cost effectiveness of stop smoking services in Wirral: 2015 update. UK:\nWirral, 2015.","Link to source","-",2019]
["I70","Smoking and Tobacco","Stop Smoking services and interventions","Smoking Cessation","No","BCR $3.12: $1 \nROI $2.12: $1","-","-","The Tobacco Cessation and Prevention Program enables individuals in Massachusetts, USA on low incomes (eligible for Medicaid) to receive medication with a prescription (FDA-approved) to aid smoking cessation. No prescription was required for nicotine replacement therapy such as gum, patches and lozenges. The programme also offered up to five sessions of telephone counselling.  This programme resulted a BCR of $3.12 and an ROI of $2.12 for every $1 invested. ","Cost-benefit analysis","Published Academic Journal","805 Massachusetts Medicaid\nbeneficiaries aged 18 to 64 years who are smokers.","Not Stated","The benefits of the program are the rate of reduction in hospital admissions for cardiovascular conditions. There was a reduction of 46% in inpatient admissions for myocardial infarctions, 49% for coronary atherosclerosis and 32% for non-specific chest pains, The total benefit of the programme was $571 for each adult Medicaid smoker and the total costs were $183 each, resulting in a BCR of $3.12 for every $1 invested. \nThe study assumes that hospital savings are equal to average costs per admission × number of averted admissions.","1.3 years","-","Benefit-Cost Ratio\nReturn on Investment","USA","Not Stated","2010 $ USD",2012,"Richard P, West K, Ku L. The return on investment of a Medicaid Tobacco Cessation\nProgramme in Massachusetts. PLoS ONE 2012;7:e29665.","Link to source","-",2019]
["J1","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Programmes for disadvantaged children","No","$6.2-$8.6:$1","-","-","Evidence based on the Perry Preschool Program, a 2-year experimental intervention for disadvantaged African-American children initially ages 3 to 4 that involved morning programs at school and afternoon visits by the teacher to the child’s home.\n\nTargeted interventions for disadvantaged children gives a CBR of 8.6, which is reduced to 6.2 when adjusted for deadweight costs (preferred estimate by authors).","Cost-benefit analysis","Published academic journal","-","Intervention group compared to control group","The intervention group were followed up at 40 years. Results summarised for CBR of 8.6:\nInitial programme cost = $26,639\nTotal benefit = $165,053, of which increased earnings ($78,010), reduced crime costs ($75,062), reduced welfare spend ($5,547), reduced education costs ($6,434).\nDeadweight costs: the impact of raising taxes to finance programmes. In this instance, the program incurs deadweight costs with initial funding but saves deadweight costs associated with taxes used to fund transfer recipients (e.g. subjects of Perry preschool programme).","c. 36 years","LA","Higher earnings, savings in welfare, reduced cost of crime","USA",0.03,"$ USD 2006",2010,"Heckman JJ, Moon SH, Pinto R, Savelyev PA, Yavitz A. The rate of return to the High Scope Perry Preschool Program. Journal of public Economics. 2010;94(1):114-28.","Link to source","Further reference (Kings Fund)","2017"]
["J2","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","£3.06-£3.66:£1","-","-","Targeted supervised tooth brushing programme gives a return of £3.06 after 5 years, £3.66 after 10 years.","Cost-benefit analysis","Published PHE ROI tool","-","-","CBR are based on a typical oral health profile and indicative costs. Benefits include NHS savings, gained days at school due to avoided dental disease, gained days at school (no financial value assigned) and gain days at work for carer (due to improved school attendance).","5 / 10 years","LA","NHS savings, increased earnings for local economy, improved productivity","England",3.5000000000000003E-2,"£ GBP",2016,"Public Health England. Oral health of children aged 0-5 years: ROI tool. 2016.","Link to source","-","2017"]
["J3","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","£2.29-£2.74:£1","-","-","Targeted fluoride varnish programme gives a return of £2.29 after 5 years, £2.74 after 10 years.","Cost-benefit analysis","Published PHE ROI tool","-","-","CBR are based on a typical oral health profile and indicative costs. Benefits include NHS savings, gained days at school due to avoided dental disease, gained days at school (no financial value assigned) and gain days at work for carer (due to improved school attendance).","5 / 10 years","LA","NHS savings, increased earnings for local economy, improved productivity","England",3.5000000000000003E-2,"£ GBP",2016,"Public Health England. Oral health of children aged 0-5 years: ROI tool. 2016.","Link to source","-","2017"]
["J4","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","£12.71-£21.98:£1","-","-","Water fluoridation gives a return of £12.71 after 5 years, £21.98 after 10 years.","Cost-benefit analysis","Published PHE ROI tool","-","-","CBR are based on a typical oral health profile and indicative costs. Benefits include NHS savings, gained days at school due to avoided dental disease, gained days at school (no financial value assigned) and gain days at work for carer (due to improved school attendance).","5 / 10 years","LA","NHS savings, increased earnings for local economy, improved productivity","England",3.5000000000000003E-2,"£ GBP",2016,"Public Health England. Oral health of children aged 0-5 years: ROI tool. 2016.","Link to source","-","2017"]
["J5","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","£1.03-£1.54:£1","-","-","Targeted provision of toothbrushes and paste by post gives a return of £1.03 after 5 years, £1.54 after 10 years.","Cost-benefit analysis","Published PHE ROI tool","-","-","CBR are based on a typical oral health profile and indicative costs. Benefits include NHS savings, gained days at school due to avoided dental disease, gained days at school (no financial value assigned) and gain days at work for carer (due to improved school attendance).","5 / 10 years","LA","NHS savings, increased earnings for local economy, improved productivity","England",3.5000000000000003E-2,"£ GBP",2016,"Public Health England. Oral health of children aged 0-5 years: ROI tool. 2016.","Link to source","-","2017"]
["J6","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","£4.89-£7.34:£1","-","-","Targeted provision of toothbrushes and paste by post and by health visitors gives a return of £4.89 after 5 years, £7.34 after 10 years.","Cost-benefit analysis","Published PHE ROI tool","-","-","CBR are based on a typical oral health profile and indicative costs. Benefits include NHS savings, gained days at school due to avoided dental disease, gained days at school (no financial value assigned) and gain days at work for carer (due to improved school attendance).","5 / 10 years","LA","NHS savings, increased earnings for local economy, improved productivity","England",3.5000000000000003E-2,"£ GBP",2016,"Public Health England. Oral health of children aged 0-5 years: ROI tool. 2016.","Link to source","-","2017"]
["J7","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","-","-","Cost-saving","Nursery tooth brushing programme including supervised tooth brushing in nurseries and toothpaste packs on six occasions for home use.\n\nSuggested total cost saving (of actual and anticipated dental treatments) of £61.51 per child after removing the programme cost of £15.78 per child. \n\nWithin three years the expected cost savings (freed-up resources) outweighed the costs of implementing the tooth brushing program and by eight years the expected cost savings were in excess of two and a half times these costs.","Cost analysis","Published academic journal","All children aged 3-5 (n= 54,812 in 2009/10).","No supervised nursery brushing","Cost analysis only, so analysis does not reflect full benefits of the programme (e.g. additional health benefits of freed-up appointments from oral health improvements as a result of the programme). The savings represent freed-up resources and not necessarily financial resources accrued on a balance sheet.\n\nAnnual cost of programme = £1.7m.\n\nCost savings vary over time (year 1 = £8m, year 4 = £10.5m, year 10 = £6m) as oral health improves.\nSensitivity analysis suggests general anaesthetic (GA) savings could range from £32 to £146 per child.\nUse Scotland cost data for GA treatment  (£653), although this has been estimated at £836 in England (so cost savings may be underestimated).\n\nDeprivation analysis suggests that cost-savings would be highest in deprived areas and lowest in least deprived areas.\n\nCosts compared in each year independently and compared using a common base year 2009/10 (so no discounting required).","10 years","LA","NHS savings","Scotland","None","£ GBP 2009/10",2015,"Anopa Y, McMahon AD, Conway DI, Ball GE, McIntosh E, Macpherson LM. Improving Child Oral Health: Cost Analysis of a National Nursery Tooth brushing Programme. PloS one. 2015 Aug 25;10(8):e0136211.","Link to source","Additional information included from oral health literature review.","2017"]
["J8","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","-","-","Cost-saving","Dental interventions to prevent dental caries and full mouth reconstructions. All of the dental interventions evaluated were shown to produce cost savings. However, the level of that cost saving is dependent on the intervention chosen.","Cost-effectiveness analysis","Published academic journal","All children aged 6-60 months in Alaska. Estimates based on child population of 2,575","Not applicable","Per child per year costs of delivering intervention:\nFluoride varnish: $662\nWater fluoridation: $278\nToothbrush/toothpaste: $605\nDental sealants: $690\nInitial exams: $ 986\n\nMinimum estimates of cost saving per child from averted caries in year one:\nFluoride varnish: $2,056 (assumed 18% effective and 100% coverage)\nWater fluoridation: $3,081 (assumed 26% effective and 68% coverage)\nToothbrush/toothpaste: $2,390 (assumed 21% effective and 100% coverage)\nDental sealants: $3,269 (assumed 71% effectiveness and 100% coverage)\nInitial exams: $ 2,682 (assumed 22% effectiveness and 100% coverage)","10 years","LA","Healthcare savings","USA",0.03,"$ USD 2011",2016,"Atkins CY, Thomas TK, Lenaker D, Day GM, Hennessy TW, Meltzer MI. Cost‐effectiveness of preventing dental caries and full mouth dental reconstructions among Alaska Native children in the Yukon–Kuskokwim delta region of Alaska. Journal of public health dentistry. 2016 Jun 1;76(3):228-40.","Link to source","-","2017"]
["J9","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","$0.29-$9.99:$1","-","Cost-saving","Dental interventions to prevent dental caries.\n\nFull water fluoridation to New York City: ROI = 9.99:1; intervention is cost-saving.\nFluoride varnish to pre-schoolers receiving Medicaid: ROI = 0.29:1\nTooth brushing: ROI = 1.48:1; intervention is cost-saving.","Systems model analysis","Published academic journal","Children under 6. Assumed 450,000 preschool children were eligible","-","Full water fluoridation to New York City:\nCost = $1,221,375\nNet savings over 10 years = $10,979,753\nROI = 9.99:1\n\nFluoride varnish to pre-schoolers receiving Medicaid (to all aged 2 years to 6 years)\nCost = $170,385,376 \nNet savings over 10 years (based on 40% reduction) = $48,601,440 \nTooth brushing (if a 50% increase in all Medicaid pre-schoolers aged 2-3\nyears) :\nCost =$15,071,346 \nNet savings over 10 years  = $22,330,792 ","10 years","LA","Disease reductions and healthcare savings","USA","-","$ USD",2015,"Edelstein BL, Hirsch G, Frosh M, Kumar J. Reducing early childhood caries in a Medicaid population: a systems model analysis. The Journal of the American Dental Association. 2015 Apr 30;146(4):224-32.","Link to source","-","2017"]
["J10","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Child oral health","No","-","-","Cost-saving","Home visits and telephone contacts in preventing early childhood caries. For every group of 100 children, the model predicted that having the home-visit intervention would save $167 032 and telephone contacts $144 709 over 5½ years relative to no intervention (usual care). Both interventions were ‘dominant,’ as they saved costs and produced health benefits over usual care.","Cost-effectiveness analysis","Published academic journal","Children aged 6-60 months (n=296). 188 home visits intervention; 58 telephone contacts intervention; 40 reference controls/usual care","No intervention - Usual care","In the oral health literature review, the trial and interventions were described in a paper by Plonka (see link #2) with data on follow up reported by Koh.\n\nProgramme costs (per person):\nHome visit: $21 \nTelephone interview: $14\nVehicle costs for home visits: $11\n\nThe home visits and telephone interventions resulted in 7 and 6 QALYs, respectively, gained over the usual care. Cost savings based on reduced dental caries  (treatment cost*treatment probabilities).\n\nSensitivity analysis showed that a lower rate of caries reduced the intervention's cost-effectiveness primarily through reducing general anaesthesia costs. ","5.5 years","LA","Healthcare savings, QALY gains for service users","Australia",0.05,"$ AUD",2015,"Koh R, Pukallus M, Kularatna S, Gordon LG, Barnett AG, Walsh LJ, Seow WK. Relative cost‐effectiveness of home visits and telephone contacts in preventing early childhood caries. Community dentistry and oral epidemiology. 2015 Dec 1;43(6):560-8.","Link to source","Plonka (Link #2)","2017"]
["J11","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Parenting interventions for the prevention of persistent conduct disorders","No","£8:£1","-","-","Parenting programmes can be targeted at parents of children with, or at risk of, developing conduct disorder,\nand are designed to improve parenting styles and parent-child relationships.\n\nThey pay back £8 over six years for every £1 invested.","Cost-benefit analysis","Published report","-","No intervention","Average cost of intervention per family is estimated at £1,177. Total gross savings over 25 years amount to £9,288 per child, including £3,368 savings to the public sector (£1,278 NHS savings) and £5,919 through reduction in crime (victim costs and lost output). Intervention will provide a positive return to the public sector in year 8 and to the NHS in year 14.\n\nNo benefits are assumed from a range of other wider impacts (e.g. improved employment prospects, reduced adult mental health issues) which are likely to be substantial, making the intervention an even better investment.\n\nAround 75% of benefits accrue between ages 7-16 (with intervention at age 5).","25 years","LA","Public sector (NHS, social services, education, criminal justice system) savings","England","-","£ GBP",2011,"Knapp M, McDaid D, Parsonage M. Mental health promotion and mental illness prevention: The economic case. 2011.","Link to source","Further reference (Kings Fund)","2017"]
["J12","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Pre-school programmes","No","£1.37-£9.20:£1","-","-","RoI on well-designed early years’ interventions significantly exceed their costs. Nine UK studies showed a similar pattern of results. Social Return on Investment studies showed returns of between £1.37 and £9.20 for every £1 invested (with an average of £3.65).","Cost-benefit analysis","Published report","-","-","Additional information on each study is provided below to navigate the referenced source.\n(1) Early years intervention to increase breastfeeding: £1.56:£1.\n(2) I CAN Early Talk, Kent - to support young people with severe speech, language and communication needs. £1.37:£1.\n(3) Wheatley Children's Centre, Doncaster - to support children to achieve goals of 'Every Child Matters': £4.60:£1.\n(4) East Dunbarton Children's Centre - to reduce the number of children being looked after and accommodated: £9.20:£1. \n(5) Stay and Play, Bournemouth - stay and play groups targeted at families with particular needs, such as English as an additional language: £2:£1.\n(6) Family Support Workers, Warwickshire - provide families with children under 5 who have additional needs with intensive one-to-one support. £4.50:£1.\n(7) Tiny Toes: Hazelmere and Loudwater Children's Centres - strongly supports expectant teenage and young mothers and their babies: £3.50:£1.\n(8) Triple P, Brock House. Somerset - parenting programme  to manage their child’s behaviour. £2.50:£1.\n(9) Oxfordshire Home Visiting to reduce child abuse - professionally delivered, intensive home visiting programme beginning during the antenatal period and continuing for one year after birth: £1.27:£1.","Various ","LA","-","England","-","£ GBP",2013,"Department for Education. Conception to age 2-the age of opportunity report. 2013.","Link to source","-","2017"]
["J13","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Home visits","No","$5.06:1","-","-","The American programme Nurse-Family Partnership, a peri-natal visit programme which has been implemented in the UK, has shown a $5.06 ROI for every dollar spent.","Cost-benefit analysis","Published academic journal","-","-","Average total costs: $7,572\nAverage total benefits: $38,296\nNet benefits: $30,724\nCBR: 5.06","-","LA","-","USA","-","$ USD",2010,"Heckman J, Grunewald R, Reynolds A. The Dollars and Cents of Investing Early: Cost-Benefit Analysis in Early Care and Education. Zero to Three. 2006 Jul;26(6):10-7.","Link to source","-","2017"]
["J14","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Pre-school programmes","No","£14.81-£17.56:£1","-","-","An economic analysis of the benefits of Every Child a Reader (Expert literacy teaching to 6 year old children who are struggling to learn to read and write) by KPMG estimated that the scheme could offer a return of £14.81-£17.56 in the next 31 years for every £1 spent now, based on the estimated costs of problems associated with poor literacy such as truancy and poor employment prospects.","Cost-benefit analysis","Published report","-","-","The scheme costs £10m over 3 years, £2,389 per child.\n\nBenefits: Savings to public purse from failure to learn to read in primary school years, estimated at between £44,797 and £53,098. For each intervention, which costs £2,389 the sum of £35,390 is saved in today’s money.\n\nEstimated savings are conservative (do not include savings that could not be readily quantified, such as economic effects of reduced spending power, social housing costs, costs of generally poorer health, intergenerational effects on literacy).\n","-","LA","Public purse (reduced health / crime / welfare / educational costs","England",3.5000000000000003E-2,"£ GBP 2006",2006,"Gross J. The long term costs of literacy difficulties: KPMG Foundation; 2006.","Link to source","-","2017"]
["J15","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Conduct disorders","No","-","-","-","Reducing conduct problems through school-based social and emotional learning.","-","Published academic journal","-","-","Costs: £132 per pupil per year Savings of £39 to health sector in first year, rising to £751 by fifth year.\nNet societal savings of £6,369 for whole of society by fifth year (mostly through reduced crime). Savings to the NHS of £1,148 by year 10","1 / 5 / 10 years","LA","NHS savings, reduce crime costs","England",3.5000000000000003E-2,"£ GBP 2009",2011,"Knapp M, McDaid D, Parsonage M. Mental health promotion and mental illness prevention: The economic case. 2011.","Link to source","-","2017"]
["J16","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Nurse Family Partnership for low income women","No","$2.88:1","-","-","The Nurse Family Partnership provides intensive visitation by nurses during a woman’s pregnancy and the first two years after birth.\n\nThe programme (implemented in the UK) has been found to generate a saving of US$2.88 for every US$1 invested. Savings are greatest when NFP is targeted at high risk groups.","Cost-benefit analysis","Published report","-","-","Cost per participant is $9.118, with benefits of reduced child maltreatment and criminal behaviour estimated at $26,298.","-","LA","-","USA","-","$ USD 2003",2004,"Aos S, Lieb R, Mayfield J, Miller M, Pennucci A. Benefits and costs of prevention and early intervention programs for youth. Olympia: Washington State Institute for Public Policy; 2004.","Link to source","-","2017"]
["J17","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Pre-school programmes","No","$2-$10:$1","-","-","Participation in preschool programs was found to have relatively large and enduring effects on school achievement and child well-being. High-quality programs for children at risk produce strong economic returns ranging from about $4 per dollar invested to over $10 per dollar invested. Even under modest assumptions, prekindergarten programs for 4-year-olds would be expected to return more than $2 per dollar invested. ","Cost-benefit analysis","Published academic journal","-","-","The amount of evidence on the positive and enduring effects of high-quality preschool programs is unprecedented, especially for children at risk. There is not only a critical mass of evidence from long-term cost-benefit analyses, but increasingly strong evidence from state-financed prekindergarten that participation is associated with sizeable increases in school readiness and transition to elementary school. These demonstrated increases in many programs are critical to the emergence of enduring effects. ","Various ","LA","Well-being and school achievement for students","USA","-","$ USD",2008,"Reynolds AJ, Temple JA. Cost-effective early childhood development programs from preschool to third grade. Annu. Rev. Clin. Psychol.. 2008 Apr 27;4:109-39.","Link to source","-","2017"]
["J18","Children 0-5 services","The Healthy Child Programme (HCP) (0-5)","Pre-school programmes","No","$2.5:$1","-","-","The Abecedarian project was a preschool program that provided intensive education during full-day child care.\n\nFor every $1 spend, there are $2.50 of benefits.\n","-","Published academic journal","Study participants were 104 economically disadvantaged children and their families.","Control group of children received mix of formal and informal care.","Undiscounted costs of $67,000 ($11k in year 1, $16k in year 2 and 3, $12k in year 4 and 5), discounted costs $63,476. \n\nTotal benefits of $158,278, including increased maternal earnings ($68k), decreased schooling costs, increased lifetime earnings ($37k), decreased childcare costs ($27k) and decreased costs related to smoking ($18k). Includes additional education costs as a result of higher educational attainment (-$8k).\n\nThe Abecedarian preschool program was educationally intensive and temporally extensive. It likely represents an upper bound on public investments in preschool education that might be realistically considered.","-","LA","Income benefits for child and mother, QALY gains for service user, other educational / welfare benefits.","USA",0.03,"$ USD 2002",2005,"Barnett WS, Masse LN. Comparative benefit–cost analysis of the Abecedarian program and its policy implications. Economics of Education Review. 2007 Feb 28;26(1):113-25.","Link to source","-","2017"]
["J19","Children 0-5 Services","Breastfeeding","Breastfeeding Support using Proactive Telephone calls","No","-",1939,"-","This intervention has been taken from PHE's Best Start in Life Tool. It provides proactive daily telephone calls from a specialised feeding team on a postnatal ward for 1 week following discharge from hospitals. \nAn ICER of £1,939 is generated against reactive telephone as a comparator intervention.","Cost-Utility Analysis","Published PHE ROI tool","Women from deprived areas (IMD England 1-3) who were breastfeeding when discharged from hospital.","The comparator intervention is reactive telephone calls where new mothers could telephone the feeding team at any time over the 2 weeks following discharge.","By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Health Benefits/QALYs are discounted at 1.5%.and costs at 3.5%. The cost of the intervention is £22.46 per person and the cost savings are £21.42 which provides a combined net benefit of -£1.04. The combined QALY gain is 0.000535, resulting in an ICER of £1,939. This intervention does not include long term benefit to the child and other benefits to the mother.","Benefits to the child: 1 year. Benefits to the mother: lifetime","-","Cost of Intervention. Effectiveness was measured as uptake of breastfeeding. QALYs gained and ICER","England","1.5% Health Benefits and\nCosts 3.5%","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Hoddinott P, Craig L, Maclennan G, Boyers D, Vale L. The Feeding Support Team (FEST) randomised, controlled feasibility trial of proactive and reactive telephone support for breastfeeding women living in disadvantaged areas. BMJ open. 2012 Jan 1;2(2):e000652.",2019]
["J20","Children 0-5 Services","Breastfeeding","Enhanced Staff Contact for Breastfeeding Mothers","No","-","Dominant","Cost Saving","This intervention has been taken from PHE's Best Start in Life Tool. Enhanced staff contact involves specifically trained staff who are available to advise and support mothers on milk expression and breastfeeding. This intervention is cost saving and delivers positive health gains. This intervention is dominant which means it is cost saving and delivers positive health gains in terms of QALYs.","Cost-Utility Analysis","Published PHE ROI tool","Mothers with infants in neonatal units","Normal Staff Contact i.e. no additional of specially trained staff.","By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. This intervention results in 0.31 QALYs gained per person with an overall cost of -£877.81. The value of a QALY is £60,000. Costs and health benefits/QALYs are discounted at 3.5%. This intervention does not include benefits to the mother.","Benefits to the Child: Lifetime ","-","Intervention cost and QALYs gained by the child. ICER","England",3.5000000000000003E-2,"£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Renfrew M J, Craig D, Dyson L, McCormick F, Rice S, King S E, Misso K, Stenhouse E, Williams A F. Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis. NIHR Health Technology Assessment programme. 2009",2019]
["J21","Children 0-5 services","Education","Intensive early education programme for socioeconomically deprived families (preschool programme)","No","$10.83 : $1","-","-","The Child-Parent Centres (CPC) are located near state primary schools and their early childhood intervention provides education and family-support services to children aged between 3 and 9. The education focuses on acquiring basic skills in languages arts (reading, writing, speaking and listening) and maths. A cost-benefit analysis (CBA) of the Child-Parent Centre (CPC) Program for pre-school children, indicated that the ratio of benefits to cost (BCR) was $10.83 from a societal perspective for each $1 invested and $7.20 from a public perspective. ","Cost-benefit analysis","Published Academic Journal","1539 participants, USA","Usual Educational Interventions / Usual Care","The preschool programme runs 3 hours per day, 5 days per week during the 9-month school year, and usually includes a 6-week summer programme. The program has a child-to-staff ratios of 17 to 2 (qualified teacher and assistant). All teachers are qualified at undergraduate level i.e. Bachelor's degrees .The average length of participation for a child was 1.55 years. The benefits include increased earnings, tax revenues, averted costs in the criminal justice system, savings in public welfare and education. The benefits per child were $92,220 at a cost of $8,512 which results in a BCR of 10.83. ","20 years","-","Benefit-Cost Ratio","USA",0.03,"$ USD 2007",2011,"Reynolds AJ, Temple JA, White BAB, et al. Age 26 cost-benefit analysis of the\nchild-parent centre early education program. Child Dev 2011;82:397404","Link to source","-",2019]
["J22","Children 0-5 services","Education","Intensive early education programme for socioeconomically deprived families (extended = preschool + school-age intervention)","No","$8.24 : $1","-","-","The Child-Parent Centres (CPC) are located near state primary schools and their early childhood intervention provides education and family-support services to children aged between 3 and 9. The education focuses on acquiring basic skills in languages arts (reading, writing, speaking and listening) and maths. A cost-benefit analysis (CBA) of the extended intervention of the Child-Parent Centre (CPC) Program for school-age children, indicated that the ratio of benefits to cost (BCR) was $8.24 from a societal perspective for each $1 invested and $5.21 from a public perspective.","Cost-benefit analysis","Published Academic Journal","553 participants, USA","Usual Educational Interventions / Usual Care","All teachers are qualified at undergraduate level i.e. Bachelor's degrees. The average length of participation for a child was 3.87 years. The benefits include increased earnings, tax revenues, averted costs in the criminal justice system, savings in public welfare and education. The benefits per child were $42,520 at a cost of $5,163 which results in a BCR of 8.24","20 years","-","Benefit-Cost Ratio","USA",0.03,"$ USD 2007",2011,"Reynolds AJ, Temple JA, White BAB, et al. Age 26 cost-benefit analysis of the\nchild-parent centre early education program. Child Dev 2011;82:397404","Link to source","-",2019]
["J23","Children 0-5 services","Nutritional Supplementation","Folic acid fortification of grain","No","$4.3 - $6.1 : $1","-","-","The aim of this intervention is to provide to folic acid supplementation by fortifying cereal grain in order to prevent neural tube defects which are linked to birth defects: Spina bifida and anencephaly. Investing $1 in low-level fortification (140 micrograms per 100g of cereal grain)  provides benefits of 4.3. Investing $1  in high-level fortification (350 mcg per 100g of grain)  provides benefits of $6.10.","Cost-benefit analysis","Published Academic Journal","Sexually active\nwomen of childbearing age","No Intervention","Benefits of fortification = Incremental Cost of each case of neural tube defect × the number of cases averted.\nThere are two categories of folic acid fortification: low at 140 micrograms and high at 350 micrograms.\nThe price of folic acid was $115 per kilogram and the unit cost of low level fortification would be $0.0095 per 100 lb (45.34kg) of grain. The unit cost of high level fortification would be $0.0237 per 100 lb (45.34kg) of grain.\nThe total cost of a case of Spina bifida is $349,133 and for anencephaly it is $485,016.\nThis study assumes that sufficient folate intake decreases the risk of a neural tube defect in pregnancy by 50%. Accordingly, the target population can be split into two subgroups. The 33% with adequate folate intake have an expected prevalence for Spina bifida is 2.7 and for anencephaly it is 1.6 (per 10,000 live births).The 67% without sufficient folate have an expected prevalence for Spina bifida is 5.5 and for anencephaly it is 3.2 (per 10,000 live births). With low level fortification, 17% of the target population would move from inadequate to sufficient intake and with high level fortification, 42% would move.","Lifetime","-","Benefit-Cost Ratio","USA",0.04,"$ USD",1995,"Romano PS, Waitzman NJ, Scheffler RM, et al. Folic acid fortification of grain:\nan economic analysis. Am J Public Health 1995;85:667–76.","Link to Source","-",2019]
["K1","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Health benefits of a good education","No","$2.25-$7:£1","-","-","Offering $1,000 of grant aid (i.e. subsidising education) results in an increase in education of 0.16 years, which translates into 0.03-0.10 years of additional life (based on 3% and 0% discount rates). This is roughly $2,250-$7,200 in present\nvalue (using a $75,000 value of a year of health).","Cost-benefit analysis","Published academic journal","-","-","Effectiveness evidence is based on Dynarski (2003).","-","LA"," Health benefits","USA","0% / 3% (health benefits)","$ USD 1998",2006,"Cutler DM, Lleras-Muney A. Education and health: evaluating theories and evidence. National Bureau of Economic Research; 2006 Jul 3.","Link to source","Dynarski (2003)","2017"]
["K2","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Conduct disorders","No","-","-","£1 spent, £8 saved","Study implies that for every £1 spent on parenting programmes to reduce conduct problems, £8 can be saved. \n\nFor Wales, the total value of prevention in a one-year cohort (33,000 births) would be £247.5 million, with the total value of promoting positive mental health amounting to £1,113.75 million. \n\nSubstantial investment in these programmes is therefore justified even if their effectiveness is limited, given the size of potential benefits relative to cost. A range of evidence suggests that success rates at the level required can be achieved in real life settings (i.e. only need 2-4% effectiveness rate, whereas literature suggests effectiveness of around 10-40%).","Cost-benefit analysis","Published report","Cohort study","-","Cohort study can be divided into three broad groups; no conduct problems at age 7-9 (50%); some conduct problems (45%) and  conduct disorder (5%). Analysis assumes MH interventions can enable 5% to achieve 45% adult outcomes (£150k savings per case, of which 71% savings in crime-related costs, 13% healthcare savings, 7% increase to lifetime earning), 45% to achieve 50% outcomes (£75k savings per case, of which 61% savings in crime-related costs, 19% healthcare savings, 9% increase to lifetime earnings).\n\nBased on cohort study in New Zealand (similar patterns observed to UK data) on prevalence of child conduct problems aged 7-9 and applied to a one-year cohort of births in Wales.\n\nIn comparison, the costs of intervention are\nvery low, ranging from £1,350 to £6,000 per\nchild for pre-school parenting programmes (£6,000 assumed as unit cost for 5% group, £1,350 for 45% group. Total costs = £29.9m.","Lifetime","LA","Primarily savings relating to crime, but also health savings and increase to lifetime earnings.","Wales",3.5000000000000003E-2,"£ GBP",2009,"Friedli L, Parsonage M. Promoting mental health and preventing mental illness: The economic case for investment in Wales. Cardiff: All Wales Mental Health Promotion Network. 2009.","Link to source","-","2017"]
["K3","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Conduct disorders","No","-","Cost-effective","-","In the incredible years (IY) parenting programme, a programme aimed at improving the skills and parenting strategies of parents of children with conduct problems, is cost-effective in reducing behavioural problems and in doing so may generate long-run economic returns.","Cost-utility analysis","Published academic journal","Children aged 3-7 years","No intervention","Net cost of intervention around €1,760.\nBenefits of intervention in form of reduced behavioural problems, measured by reduction in Eyberg Child Intensity Score (ECIS), which gives an idea of severity of disruptive behaviour.\n\nAnalysis estimates a cost of €87 per 1 point reduction in score, which is consistent with a study of the IY programme in Wales (€83). Based on the mean ECIS score pre-intervention (158), the  cost of bringing the average child below the cut-off is €2,784 (32 point decrease).\n\nLong-term effects are not included in results of study, although literature suggests favour returns in terms of reduced crime (prison costs), unemployment (welfare) and education (reduced staff costs).","6 months","LA","Reduced behavioural problems for service user.","Ireland","None","€ EUR",2013,"O’Neill D, McGilloway S, Donnelly M, Bywater T, Kelly P. A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities. The European Journal of Health Economics. 2013 Feb 1;14(1):85-94.","Link to source","-","2017"]
["K4","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-",5278,"-","Social and emotional wellbeing in primary education (ages 7-11). Universal mental health promotion intervention (emotion + cognition) requires 3x 20 minute sessions per week for each class run by a teacher. \n\nThe expected ICER for this intervention is £5,278 per QALY.","Cost-utility analysis","Published NICE guidance","-","No intervention","The total cost per child per year is £125, of which £84 is salary costs of teacher, £41 salary costs of school co-ordinator, £1 materials. Each teacher attends a 3 day training course with a half day refresher at Y2 and Y3. A school co-ordinator also manages the intervention and delivers parent training (10 week session, 2 hours per week). The intervention lasts for 3 years and commences in year 3; i.e. at the start of\nthe primary school. The effect is assumed to be maintained in year 6, even though the intervention stops at the end of year 5. \n\nHealth Utilities Index (HUI) has been used to estimate health status and health-related quality of life (using questionnaire responses).The mean utility estimated in the model ranges from 0.77-0.86 (depending on primary school year).\n\nThe analyses are exploratory, reflecting the nature of the evidence base for the effectiveness of these interventions. They do not take account of the costs to parents of attending the parent training programme, nor any sustained health,\neducational or socio-economic benefits of the intervention. The results should be interpreted with caution. ","3 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"McCabe C. Estimating the short-term cost effectiveness of a mental health promotion intervention in primary schools. NICE, London. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH12).","2017"]
["K5","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-",9600,"-","Internet-based expert system + peer initiative to reduce bullying and victimisation has an ICER of £9,600 per QALY if the intervention is effective in delivering a sustained reduction of victimisation of 15%.\n\nResults must be interpreted with caution. The estimation of the effectiveness of an anti-bullying intervention is based on very limited evidence, and estimates of victimisation prevalence are highly variable.","Cost-utility analysis","Published academic journal","-","No intervention","The annual cost of the classroom intervention is estimated to be £7,300 and the peer mediation programme £3,900. It is\nestimated that reduction of time spent by teachers intervening in student disputes may save £1,900, giving a net total cost for a school with 600 pupils aged 11-16 of £9,300 per year. The estimated cost per pupil is £15.50 per year. \n\nThe model assumes that benefits only accrue to victims of bullying, through lower utility measured as QALY losses (0.54 non discounted / 0.22 discounted) and reduced lifetime income (£50,000 non discounted, £14,000 discounted). Other potential cost-savings arising from reduced crime and mental health problems are not included in the model so the model may underestimate the benefits of interventions to reduce bullying. There will also be benefits to the Exchequer (increased tax revenues and savings in welfare spend).","Lifetime","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2009,"Hummel S, Naylor P, Chilcott J, Guillaume L, Wilkinson A, Blank L, Baxter S, Goyder L. Cost effectiveness of universal interventions which aim to promote emotional and social wellbeing in secondary schools. Sheffield, UK: University of Sheffield. 2009.","Link to source","Based on evidence from evaluations conducted by NICE (PH12).","2017"]
["K6","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-",10594,"-","Social and emotional wellbeing in primary education. Universal mental health promotion intervention (emotional function only)  requires 3x 20 minute sessions per week for each class run by a teacher.","Cost-utility analysis","Published NICE guidance","-","No intervention","The total cost per child per year is £125, of which £84 is salary costs of teacher, £41 salary costs of school co-ordinator, £1 materials. Each teacher attends a 3 day training course with a half day refresher at Y2 and Y3. A school co-ordinator also manages the intervention and delivers parent training (10 week session, 2 hours per week). The intervention lasts for 3 years and commences in year 3; i.e. at the start of\nthe primary school. The effect is assumed to be maintained in year 6, even though the intervention stops at the end of year 5. \n\nHealth Utilities Index (HUI) has been used to estimate health status and health-related quality of life (using questionnaire responses).The mean utility estimated in the model ranges from 0.77-0.86 (depending on primary school year).\n\nThe analyses are exploratory, reflecting the nature of the evidence base for the effectiveness of these interventions. They do not take account of the costs to parents of attending the parent training programme, nor any sustained health, educational or socio-economic benefits of the intervention. The results should be interpreted with caution. ","3 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"McCabe C. Estimating the short-term cost effectiveness of a mental health promotion intervention in primary schools. NICE, London. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH12).","2017"]
["K7","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-",177560,"-","Social and emotional wellbeing in primary education (ages 7-11). Focussed intervention (two-level improvement)  requires 3x 20 minute sessions per week for each small group / individual, who have identified problems and is delivered in a setting outside the classroom. \n\n\nThe expected ICER for this intervention is £177,560 per QALY.","Cost-utility analysis","Published NICE guidance","-","No intervention","The total cost per child per year is £125, of which £84 is salary costs of teacher, £41 salary costs of school co-ordinator, £1 materials. Each teacher attends a 3 day training course with a half day refresher at Y2 and Y3. A school co-ordinator also manages the intervention and delivers parent training (10 week session, 2 hours per week). The intervention lasts for 3 years and commences in year 3; i.e. at the start of\nthe primary school. The effect is assumed to be maintained in year 6, even though the intervention stops at the end of year 5. \n\nHealth Utilities Index (HUI) has been used to estimate health status and health-related quality of life (using questionnaire responses).The mean utility estimated in the model ranges from 0.77-0.86 (depending on primary school year). \n\nThe analyses are exploratory, reflecting the nature of the evidence base for the effectiveness of these interventions. They do not take account of the costs to parents of attending the parent training programme, nor any sustained health, educational or socio-economic benefits of the intervention. The results should be interpreted with caution. ","3 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"McCabe C. Estimating the short-term cost effectiveness of a mental health promotion intervention in primary schools. NICE, London. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH12).","2017"]
["K8","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-",988404,"-","Social and emotional wellbeing in primary education (ages 7-11). Focussed intervention (1 level improvement) requires 3x 20 minute sessions per week for each small group / individual, who have identified problems and is delivered in a setting outside the classroom. \n\n\nThe expected ICER for this intervention is £988,404 per QALY.","Cost-utility analysis","Published NICE guidance","-","No intervention","The total cost per child per year is £125, of which £84 is salary costs of teacher, £41 salary costs of school co-ordinator, £1 materials. Each teacher attends a 3 day training course with a half day refresher at Y2 and Y3. A school co-ordinator also manages the intervention and delivers parent training (10 week session, 2 hours per week). The intervention lasts for 3 years and commences in year 3; i.e. at the start of\nthe primary school. The effect is assumed to be maintained in year 6, even though the intervention stops at the end of year 5. \n\nHealth Utilities Index (HUI) has been used to estimate health status and health-related quality of life (using questionnaire responses).The mean utility estimated in the model ranges from 0.77-0.86 (depending on primary school year).\n\nThe analyses are exploratory, reflecting the nature of the evidence base for the effectiveness of these interventions. They do not take account of the costs to parents of attending the parent training programme, nor any sustained health,\neducational or socio-economic benefits of the intervention. The results should be interpreted with caution. ","3 years","LA","QALY gains for service users","England",3.5000000000000003E-2,"£ GBP",2008,"McCabe C. Estimating the short-term cost effectiveness of a mental health promotion intervention in primary schools. NICE, London. 2008.","Link to source","Based on evidence from evaluations conducted by NICE (PH12).","2017"]
["K9","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","£7.5:£1","-","-","Counselling support services, including 1-1 counselling and a self-referral service for children and young people, give a CBR of 7.5:1. This includes reduced costs associated with social services, welfare benefits and the criminal justice system.\n\nCosts of the intervention are repaid after 5 years, with cost savings accruing in the years after.","Cost-benefit analysis","Published report","2,344 children receiving individual and group counselling from The Place2Be in one year.","No control group (children at risk who are not treated is not an option)","Economic analysis shows that counselling services cost £2 million. Benefits were in the form avoidance of long-term mental disorders and mental health problems over their lifetime (estimated at 112 cases), with a consequent saving of some £15 million in health and welfare spending, lost productivity and other costs to the national economy.\n\nThese results must be interpreted with caution, as some of the evidence is necessarily speculative and there are gaps in the data.","Lifetime","LA","Users without mental health problems, savings in health and welfare spend, lost productivity.","England",3.5000000000000003E-2,"£ GBP 2007/08",2010,"The Place2Be. Cost Effective Positive Outcomes for Children and Families: An economic analysis of The Place2Be’s integrated school based services for children. London; 2010.","Link to source","Referenced in PHE source","2017"]
["K10","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Child mental health","No","-","-","Dominant","Problem-solving therapy for people who deliberately self-harm.","Cost-utility analysis","Published academic journal","-","-","260 DALYs averted at a cost of $4 million  and healthcare cost savings of $16 million.\n\nAuthor notes that study is well evaluated and, importantly, has evidence of both efficacy and effectiveness—that is, evidence that they work under routine health-service conditions as well as in controlled experimental conditions. \n\nWorkforce availability to provide intervention  is noted as an issue for implementation. ","Lifetime","LA","DALYs averted for service users","Australia",0.03,"$ AUD",2011,"Mihalopoulos C, Vos T, Pirkis J, Carter R. The economic analysis of prevention in mental health programs. Annual review of clinical psychology. 2011 Apr 27;7:169-201.","Link to source","-","2017"]
["K11","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Class-size reductions","No","$1.38-2.79:$1","-","-","Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested.\n\nReducing class sizes in kindergarten (5-6 years old: $2.79 per dollar invested) through second grade (7-8 years) was more cost-effective than reducing class sizes in middle / high school ($1.38 per dollar invested).","Cost-benefit analysis","Published report","-","-","\nCost: One unit drop in class size $217 per student per year (increased operating and capital costs).\nOutcomes: Based on higher test scores, with associated increase in adult earnings ($581).","-","LA","Higher test scores, with associated increase in adult earnings.","USA",0.05,"$ USD 2006",2007,"Aos S, Miller MG, Mayfield J. Benefits and costs of K-12 educational policies: evidence-based effects of class size reductions and full-day kindergarten. Washington State Institute for Public Policy; 2007.","Link to source","-","2017"]
["K12","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Class-size reductions","No","$1.38-2.79:$1","-","-","Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested.\n\nReducing class sizes in kindergarten (5-6 years old: $2.79 per dollar invested) through second grade (7-8 years) was more cost-effective than reducing class sizes in middle / high school ($1.38 per dollar invested).","Cost-benefit analysis","Published report","-","-","\nCost: One unit drop in class size $217 per student per year (increased operating and capital costs).\nOutcomes: Based on higher test scores, with associated increase in adult earnings ($581).","-","LA","Higher test scores, with associated increase in adult earnings.","USA",0.05,"$ USD 2006",2007,"Aos S, Miller MG, Mayfield J. Benefits and costs of K-12 educational policies: evidence-based effects of class size reductions and full-day kindergarten. Washington State Institute for Public Policy; 2007.","Link to source","-","2017"]
["K13","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Class-size reductions","No","$1.38-2.79:$1","-","-","Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested.\n\nReducing class sizes in kindergarten (5-6 years old: $2.79 per dollar invested) through second grade (7-8 years) was more cost-effective than reducing class sizes in middle / high school ($1.38 per dollar invested).","Cost-benefit analysis","Published report","-","-","\nCost: One unit drop in class size $217 per student per year (increased operating and capital costs).\nOutcomes: Based on higher test scores, with associated increase in adult earnings ($581).","-","LA","Higher test scores, with associated increase in adult earnings.","USA",0.05,"$ USD 2006",2007,"Aos S, Miller MG, Mayfield J. Benefits and costs of K-12 educational policies: evidence-based effects of class size reductions and full-day kindergarten. Washington State Institute for Public Policy; 2007.","Link to source","-","2017"]
["K14","Children 5-19 Public Health Programmes","The Healthy Child Programme (HCP) (5-19)","Class-size reductions","No","$1.38-2.79:$1","-","-","Class-size reductions show evidence of positive effects, with economic returns of roughly $3 per dollar invested.\n\nReducing class sizes in kindergarten (5-6 years old: $2.79 per dollar invested) through second grade (7-8 years) was more cost-effective than reducing class sizes in middle / high school ($1.38 per dollar invested).","Cost-benefit analysis","Published report","-","-","\nCost: One unit drop in class size $217 per student per year (increased operating and capital costs).\nOutcomes: Based on higher test scores, with associated increase in adult earnings ($581).","-","LA","Higher test scores, with associated increase in adult earnings.","USA",0.05,"$ USD 2006",2007,"Aos S, Miller MG, Mayfield J. Benefits and costs of K-12 educational policies: evidence-based effects of class size reductions and full-day kindergarten. Washington State Institute for Public Policy; 2007.","Link to source","-","2017"]
["K15","Children 5-19 Public Health Programmes","Education","Multisystematic therapy with serious juvenile offenders and their siblings","No","$5.04:$1 ","-","-","Multisystemic therapy (MST) is a family-based treatment for criminal activity of serious juvenile offenders. Investing $1 in this program results in $5.04 (BCR for sibling pairs) saved by taxpayers and victims of crime, over 25 years. From a referred youth (narrower) perspective, the BCR is 4.78 over the same time horizon.","Cost-benefit analysis","Published Academic Journal","305 in total which comprises: 176 serious juvenile offenders and 129 of their closest in-age siblings.","Individual Therapy","All monetary values were adjusted to 2012 using the Consumer Price Index (CPI: Bureau of Labor Statistics, 2012) and the benefit-cost ratio was calculated on an incremental basis. The benefit of MST to taxpayers and victims of crime were summed together and then the benefit of Individual Therapy (IT) was subtracted in order to calculate an incremental expected benefit. Similarly, the costs of delivering IT was subtracted from the cost of providing MST to calculate an incremental cost. The benefit to taxpayers covers the reduction in criminal justice system costs such as police, court processing and community supervision.","25 years","-","Reduction in Criminality, Benefit-Cost Ratio","USA",0.03,"$ USD",2014,"Dopp AR, Borduin CM, Wagner DV, et al. The economic impact of multisystemic\ntherapy through midlife: a cost-benefit analysis with serious juvenile offenders and\ntheir siblings. J Couns Clin Psychol 2014;82:694–705.","Link to source","-",2019]
["K16","Children 5-19 Public Health Programmes","Education","Multisystematic therapy with serious juvenile offenders","No","$23.59-$9.51 : $1","-","-","A cost-benefit analysis of multisystemic therapy (MST) against individual\ntherapy (IT) for serious juvenile offenders, demonstrated that for every $1 spent on MST resulted in a BCR of $9.51 saving for one victimisation per arrest and $23.59 saving for multiple victimisations per arrest.","Cost-benefit analysis","Published Academic Journal","Participants were 176 individuals who originally participated in a randomized clinical trial (Borduin et al., 1995) and were subsequently tracked in a 13.7-year follow-up of criminal activity (range 11.8 –15.2 years; SD 1.2 years; \nSchaeffer & Borduin, 2005).","Individual Therapy","Effectiveness of the programme was measured as the difference in arrests between the MST and IT group. The benefits were defined as averted costs in the criminal justice system and averted costs to victims including damage to and loss of property, healthcare and lost productivity as well as intangible costs such as pain and lower quality of life. The cost of MST was $10,882 compared to $2,055 for IT, an incremental cost of $8,827. The benefits are calculated using two methods: the first assumes that each arrest has one victim resulting in a conservative BCR estimate of ($75,110 + $8,827)/($8,827) = 9.51. The second method assumes each arrest has multiple victims therefore greater savings if avoided, with a BCR of ($199,374+$8,827)/($8,827) = 23.59","13.7 years","-","Benefit-Cost Ratio","USA",0.03,"$ USD",2010,"Kleitz SJ, Borduin CM. Cost-benefit analysis of multisystematic therapy with serious\nand violent juvenile offenders. J Fam Psychol 2010;24:657–66.","Link to source","-",2019]
["K17","Children 5-19 Public Health Programmes","Education","Universal school nursing services provided by Massachusetts Essential School Health Services","No","$2.20","-","-","This is a cost-benefit analysis of the Massachusetts Essential School Health Services. The ESHS program provided benefits of $177 million to society at a cost of $79.0 million, resulting in a BCR of $2.20 for every $1 invested. ","Cost-benefit analysis","Published Academic Journal","School age children","No Intervention/No School Nursing Services","The programme benefits are the difference in averted costs between having a full-time registered nurse in ESHS schools and having no school nursing services. A societal perspective has been adopted which includes direct medical costs (nurse salary and medical supplies), lost teacher productivity due to addressing student health needs and lost parental productivity due to students' absenteeism and medical administration.\nThe value of a lost hour of work is $18 and parental productivity loss is calculated using estimated mean annual earnings of $36,206.","1 year","-","Benefit-Cost Ratio","USA","None","2009 $USD",2013,"Wang LY, Vernon-Smiley M, Gapinski MA, et al. Cost benefit study of school\nnursing services. JAMA Pediatr 2013;5441:642–8.","Link to Source","-",2019]
["L1","Mental Health","Investing in social and emotional learning","School based resilience","No",5.08,"-","-","Costs avoided by NHS and families, and some small impacts on schools. In addition (not quantified in ROI tool), benefits to school and children related to short term improvements in academic performance","ROI tool","ROI tool","Pupils in Year 7, Key Stage 3 (Age 11-12)","No intervention","Incidence of depression = 0.06\nRate of participation in classes 0.6\nMean reduction in school absence\nGP costs = £27.73\nHospital costs = £122.87\nTraining cost per teacher per school year £519","7 years","Schools (education sector)\n","QALYs\nNHS savings\nLA savings\nFamily savings\nSchool savings\n","England","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L2","Mental Health","Investing in school based interventions","School anti-bullying programme","No",1.58,"-","-","Outcome evidence on likelihood of avoiding bullying drawn from RCT in Finland. Outcomes per pupil over 4 year period and costs to school of delivery. Benefits to families, schools and health sector.","RCT","ROI tool","Children aged between 7 -11","No intervention","\nAverage number of days per year absent if bullied = 28 \nCost per day of absence per pupil = £46.9\n","4 years","Schools (education sector)\n","NHS savings\nFamily savings\nSchool attendance\nChildren and adolescent mental health (CAMH)","Finland","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L3","Mental Health","Investing in a workplace wellbeing programme","Universal workplace wellbeing programme","No",2.37,"-","-","Based on results of a peer reviewed publication of findings from a randomised control programme in a UK workplace. Outcomes over 1 year period and costs to workplace estimated.","RCT","ROI tool","N/A","No intervention","Health promotion programme per employee = £82.1\nUptake of intervention = 0.1\nHours of absence per month = £4.32\nHours of presenteeism per month £6.32","1 year","Employer\nNHS","Impacts on presenteeism and absenteeism work\n","United Kingdom","N/A","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L4","Mental Health","Investing in workplace stress programme","Universal provision of workplace CBT service","No",2,"-","-","Multi-component universal provision of CBT for local authority employees in Wales. Outcomes over a 2 year period and costs to workplace estimated.","Multi-component programme","ROI tool","Working age population 18 - 67 (local authority employees in Wales)","No intervention","Probability of completing CBT intervention = 0.66\n% of employees in need of support = 0.0138\nCosts of stress reduction programme per worker = £3.41","2 years","Local authority\nNHS","Impacts on presenteeism, absenteeism, staff retention as well as contact with GP's, secondary health services and local authority wellbeing services","Wales","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L5","Mental Health","Providing support for people in debt","Free debt advice delivered by an not-for-profit organisation within a GP","No",2.6,"-","-","A free debt advice service for adults experiencing problematic debt, but who are without mental health problems. The intervention is delivered by a not-for-profit organisation provided within a practice or surgery. From a health system perspective, debt advice services are likely to have a positive return on investment, particularly if the bulk of the costs of the service are borne by creditors or the financial industry. Economic pay offs should include NHS impacts, legal system costs and productivity gains.","RCT","ROI tool","Population aged 18 and over in England","No intervention","Average debt arrears = £6000\nDevelopment of mental health problem = 6.3%\nDevelopment of persistent depression = 33%\nProportion of those in debt who are employed =30%\nUnit cost of face to face consultation £128\nCost of GP training on financial awareness = £1050","5 years","Finance industry\nNHS\nLocal authorities","Impacts on NHS\nLegal system savings\nWorkplace productivity","England","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L6","Mental Health","Suicide and self-harm prevention programmes","Increased use of psychosocial assessment in A&E  to help reduce risk of further self-harm events","No",2.93,"-","-","Adults are identified as being at risk of suicidal behaviour and who present at hospital following a self-harm event. This intervention has the long term potential to be cost saving from an NHS perspective and the ROI increases when impacts on other sectors are taken into account. Important to recognise this strategy needs to be combined with other approaches at national  level. This is to restrict access to means of suicide and measures to train gate keepers to identify, refer and make suicide hotspots (bridges, railway lines etc.) safer.","Cost-benefit analysis","ROI tool"," -","No intervention","A&E investigation + £170\nCosts of coroner = £569\nIntangible value of loss of life = £38,797\nPolice costs per suicide = £653\nCost of psychosocial assessment = £232\nProductivity losses per year of life lost = £19,327\nIncidence of self-harm in population = 0.4%","10 years","NHS","NHS services\nLocal authority costs\nPolice costs\nProductivity losses related to self-harm and suicide\n","England","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L7","Mental Health","Tackling loneliness and social isolation in older adults","Provision of signposting service and subsequent participation in group activities","No","£1..26","-","-","Randomised trial looking at impact on depression from participation in group based activities in England, in addition to non-controlled evidence from experience of provision of signposting services in England. Evidence of impact of loneliness on depression taken from meta analyses. Consistent with recent NICE guidance on promoting the mental health and wellbeing of older people.\n\n","RCT and non-controlled evidence used","ROI tool","Individuals over 65 and not in work that self-identify as being lonely ","No intervention","Mean A&E attendance  if lonely = 0.26\nHospital admission if not lonely = 0.25\nMean number of contacts per GP practice per year = 7.63\nUnderlying probability of death = 0.01\nProbability depression if not lonely = 0.012\nProbability depression sometimes lonely = 0.012\nHourly value of volunteering = £6.70\nVolunteer hours = 156\n\nIntervention taken from meta-analyses of longitudinal studies","5 years","Local authorities","NHS services\nIncrease in volunteering and loneliness averted","England","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L8","Mental Health","Investing in collaborative care for people with long-term physical health problems","Collaborative care involving cognitive behavioural therapy delivered within primary care","No",1.52,"-","-","Collaborative care focused on individuals living with diabetes and/or coronary heart disease in England. Positive return on investment when productivity costs included. Favourable cost per QALY gained from health and social care system perspective.","ROI tool","ROI tool","Individuals living with diabetes and/or coronary heart disease","No intervention","New cases of depression in the general population = 0.012\nStill has depression at 4 months with collaborative care = 0.57\nStill has depression at 4 months with usual care = 0.72\nProbability depression if one has physical health problems = 0.37\nProbability of being employed = 0.745\nRate of employment in people depression = 0.6\nCost of collaborative care = £168","2 years","NHS","Economic pay offs to health and social care services as well as impacts on productivity","England","3.5%  costs\n\n1.5% benefits","£ GBP",2017,"PHE Mental health ROI tool","-","https://www.gov.uk/government/publications/mental-health-services-cost-effective-commissioning",2019]
["L9","Mental Health","Investing in depression interventions","Health visiting and reducing post-natal depression","No","£0.80 : £1",4500,"-","Health visitors are well placed to identify mothers suffering from postnatal depression and to provide preventative screening and early interventions. A range of UK trials with interventions provided by health visitors have been positive: women were more likely to recover fully after 3 months; targeted ante-natal intervention with high-risk groups was shown to reduce the average time mothers spent in a depressed state and a combination of screening and psychologically informed sessions with health visitors was clinically effective 6 and 12 months after childbirth.","Modelling","Published research literature"," -","No intervention","-","12 months","-","RoI, ICER","UK",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L10","Mental Health","Investing in parenting interventions ","Parenting interventions for the prevention of persistent conduct disorders","No","£7.89 : £1","-","-","Parenting programmes can be targeted at parents of children with, or at risk of, developing conduct disorder, and are designed to improve parenting styles and parent-child relationships. The median cost of an 8–12 week group-based parenting programme is estimated at £952 per family, while that of individual interventions is £2,078","Modelling","Published research literature","5 year old children","No intervention","-","25 years","-","RoI, NHS savings","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L11","Mental Health","Investing in school based interventions","School-based social and emotional learning programmes to prevent conduct problems in childhood","No","£83.73 : £1","-","-","School-based Social and Emotional Learning (SEL) programmes help children and young people to recognise and manage emotions, set and achieve positive goals, appreciate the perspectives of others, establish and maintain positive relationships, make responsible decisions and handle interpersonal situations constructively. International evidence shows that SEL participants demonstrate significantly improved social and emotional skills, attitudes, behaviour, and academic performance.","Modelling","Published research literature","10 year old children","No intervention","Intervention cost: £132 per child per year","10 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L12","Mental Health","Investing in psychosis interventions","Early detection for psychosis","No","£10.27 : £1","-","Cost saving","Early detection services aim to identify the early symptoms of psychosis, reduce the risk of transition to full psychosis and shorten the duration of untreated psychosis for those who do develop it. Such services include the provision of sessions of cognitive behavioural therapy, psychotropic medication, and contact with psychiatrists; this contrasts with treatment as usual which typically consists of GP and counsellor contacts.","Modelling","Published research literature"," -","No intervention","-","-","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L13","Mental Health","Investing in psychosis interventions","Early intervention for psychosis","No","£17.97 : £1","-","-","Early intervention teams aim to reduce relapse and readmission rates for patients who have suffered a first episode of psychosis, and to improve their chances of returning to employment, education or training, and more generally their future quality of life. Such intervention involves a multidisciplinary team that could include a range of professionals (psychiatrists, psychologists, occupational therapists, community support workers, social workers, vocational workers). The emphasis is on an assertive approach to maintaining contact\nwith the patient and on encouraging a return to normal vocational pursuits. In the UK evidence has shown that early intervention can reduce relapse and readmission to hospital and to improve quality of life.","Modelling","Published research literature","Young people aged 15 to 35 years in the general population","No intervention","-","10 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L14","Mental Health","Investing in school based interventions","School-based interventions to reduce bullying","No","£14.35 : £1","-","-","Anti-bullying programmes in schools show mixed results, depending on the design of the intervention and its implementation. That said, there is a consensus in the literature that whole-school programmes with a range of components operating at different levels within the school are more effective in reducing the prevalence of bullying than curriculum-based programmes. One high-quality evaluation of a school-based anti-bullying intervention found a 21–22% reduction in the proportion of children victimised. Benefits include improvements in the emotional, physical and social health of victims, school attendance and educational attainment, all of which are associated with better long-term employment and earnings outcomes.","Modelling","Published research literature"," -","No intervention","-","-","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L15","Mental Health","Investing in alcohol misuse interventions","Screening and brief intervention in primary care for alcohol misuse","No","£11.75 : £1","-","-","Effective strategies to reduce alcohol-related harm require a combination of measures, covering both population-level approaches (such as price increases and advertising controls) and interventions aimed at individuals. In the latter category, evidence indicates that brief interventions in primary care settings achieve an average 12.3% reduction in alcohol consumption per individual. However, this is a short-term effect and evidence about its duration is less clear cut. ","Modelling","Published research literature"," -","No intervention","-","7 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L16","Mental Health","Investing in workplace stress programme","Promoting well-being in the workplace","No","£9.69 : £1","-","-","A multi-component health promotion intervention of the sort modelled in the current study consists of personalised health and well-being information and advice; a health risk appraisal questionnaire; access to a\ntailored health improvement web portal; wellness literature; and seminars and workshops focused on identified wellness issues. A quasi experimental evaluation of this type of programme has reported significantly reduced stress levels, reduced absenteeism and reduced presenteeism, compared with a control group. Promotion of long-term mental well-being may be associated with reduced longer term risk of poor\nmental health, although the evidence for this remains weak.","Modelling","Published research literature","500 white collar employees","No intervention","The cost of a multi-competent intervention is estimated at £80 per employee per year","1 year","-","RoI","UK",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L17","Mental Health","Providing support for people in debt","Debt and mental health","No","£3.55 : £1","-","-"," The current evidence suggests that there is potential for debt advice interventions to alleviate financial debt, and hence reduce mental health problems resulting from debt. For the general population, contact with face to-face advice services is associated with a 56% likelihood of debt becoming manageable, while telephone services achieve 47%. In comparison, around one-third of problem debt may be resolved without any intervention. ","Modelling","Published research literature","Working age adults without mental health problems","No intervention","For greatest cost-effectiveness, careful consideration needs to be given to models of financing and to the mix between face-to-face, telephone and web-based provision.","5 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L18","Mental Health","Suicide and self-harm prevention programmes","Population-level suicide awareness training and intervention","No","£43.99 : £1","-","Cost saving","The cost of this type of intervention has several components. A course of ten sessions of CBT in the first year is around £400 per person. Further ongoing pharmaceutical and psychological therapy is estimated to cost\n£1,182 a year (2009 prices). The cost of suicide prevention training for GPs, based on the Applied Suicide Intervention Skills Training (ASIST) course, is £200 which would mean a total cost of around £8m if delivered to all GPs in England","Modelling","Published research literature","GP patients in England","No intervention","-","10 years","-","RoI","England",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L19","Mental Health","Suicide and self-harm prevention programmes","Bridge safety measures for suicide prevention","No","£54.45 : £1","-","-","Bridges provide obvious jumping sites, and the construction of safety barriers has been shown successfully to reduce suicides on particular bridges. It appears that these averted suicides are not simply displaced to other, unsecured jumping sites, but whether suicide occurs by another method is difficult to analyse.","Modelling","Published research literature"," -","No intervention","-","10 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L20","Mental Health","Investing in depression interventions","Collaborative care for depression in individuals with Type II diabetes","No","£0.33 : £1",3614,"-","Collaborative care’ can be delivered in a primary care setting to individuals with co-morbid diabetes and depression. Like ‘usual care’, collaborative care includes GP advice and care, the use of antidepressants and cognitive behavioural therapy (CBT) for some patients. The difference is that for collaborative care a GP practice nurse acts as a case manager for patients receiving care; GPs also incur additional time costs liaising with practice nurses. ","Modelling","Published research literature","Patients with newly diagnosed cases of Type 2 diabetes who screen positive for depression.","No intervention","-","2 years","-","RoI and ICER","England",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L21","Mental Health","Investing in medical interventions","Tackling medically unexplained symptoms","No","£1.75 : £1",3402,"-","A course of CBT may last for 10 sessions at £40 per session. Costs associated with the need to raise the awareness of GPs to the potential role of CBT treatment for somatoform conditions, either through e-learning or (much more expensively) face-to-face training are also included. These include costs associated with encouraging GPs to attend regional workshops prior to e-learning, and the costs of lcums while GPs are attending face-to-face courses.","Modelling","Published research literature","Working age individuals in England who present to GPs with somatoform","No intervention","The model relies on evidence of effectiveness from US studies, which may or may not be generalisable to an English context","3 years","-","RoI and ICER","England",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L22","Mental Health","Tackling loneliness and social isolation in older adults","Befriending of older adults","No","£0.44 : £1","-","-","In a typical befriending intervention, a befriender visits a person in their home, usually on a one-to-one basis, where that individual has requested and agreed to such a contact. The intervention is not usually structured and nor does it have formally-defined goals. Instead an informal, natural relationship develops between the participants, who will usually have been matched for interests and preferences. This relationship facilitates improved mental health, reduced loneliness and greater social inclusion.","Modelling","Published research literature"," Lonely and isolated individuals aged over 50","No intervention","The contact is generally for an hour per week or fortnight. The cost to public services of 12 hours of befriending contact is estimated at £85, based on the lower end of the cost range for befriending interventions.","-","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L23","Mental Health","Investing in workplace stress programme","Workplace screening for depression and anxiety disorders","No","£5.03 : £1","-","Cost saving","Workplace-based enhanced depression care consists of completion by employees of a screening questionnaire, followed by care management for those found to be suffering from, or at risk of developing, depression and/or anxiety disorders. Those identified as being at risk of depression or anxiety disorders are offered a course of cognitive behavioural therapy (CBT) delivered in six sessions over 12 weeks. This intervention has been shown in a number of studies to be effective in tackling depression and reducing\nproductivity losses in various workplaces. In a similar approach in Australia, productivity improvements outweighed the costs of the intervention.","Modelling","Published research literature","Working age individuals in a white collar enterprise with 500 FT equivalent ","No intervention","-","2 years","-","RoI","-",3.5000000000000003E-2,"£ GBP 2009 prices",2011,"-","Link to source","-",2019]
["L24","Mental Health","Postnatal Depression","Midwifery Redesigned Postnatal Care","No","-","Dominant","Cost Saving","This intervention has been taken from PHE's Best Start in Life Tool. It involves redesigned community postnatal care that includes changes to systematic identification and management of women's health problems, which is led by midwives with GP contact only when required. This intervention is dominant which means it is cost saving and delivers positive health gains in terms of QALYs.","Cost-Utility Analysis","Published PHE ROI tool","Individual GPs were randomly selected from a list of all GP Practices in the West Midlands Health Region (Strategic Health Authority). All pregnant women registered with the selected GPs, antenatally from approximately 34 weeks gestation, were recruited. ","Usual Care","This intervention results in 0.1270 combined QALYs gained per person with an overall cost saving of £455 (described as a combined net benefit in the BSIL tool). By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are discounted at 3.5%","Benefits to the child: Lifetime. Benefits to the mother: up to 10 years after birth.","-","Intervention cost and QALYs gained by the mother and child. ICER","England",3.5000000000000003E-2,"£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Macarthur et al., 2002)",2019]
["L25","Mental Health","Postnatal Depression","Peer Support Intervention","No","-","Dominant","Cost Saving","This intervention has been taken from PHE's Best Start in Life Tool. It involves proactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation. It is provided by a volunteer recruited from the community who had previously experienced and recovered from self-reported PND and attended a four hour training session. This intervention is dominant which means it is cost saving and delivers positive health gains in terms of QALYs.","Cost-Utility Analysis","Published PHE ROI tool","Mothers at risk of PND defined as a score of 9 or more on the Edinburgh Postnatal Depression Scale (EPDS).","Usual Care","This intervention results in 0.1320 QALYs gained per person with an overall cost saving £109 (described as a combined net benefit in the BSIL tool). By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are discounted at 3.5%","Benefits to the child: Lifetime. Benefits to the mother: up to 10 years after birth.","-","Intervention cost and QALYs gained by the mother and child. ICER","England",3.5000000000000003E-2,"£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Barnes et al., 2009)",2019]
["L26","Mental Health","Postnatal Depression","Group Physical Therapy","No","-","Dominant","Cost Saving","This intervention has been taken from PHE's Best Start in Life Tool. The group physical therapy involves an 8 week programme of 1 hour group physical therapy provided by a physical therapist and a 30 minute education session delivered by a healthcare professional each week. This intervention is dominant which means it is cost saving and delivers positive health gains in terms of QALYs.","Cost-Utility Analysis","Published PHE ROI tool","161 recent mothers discharged from postnatal ward.","Usual Care","This intervention results in 0.1256 QALYs gained per person with an overall cost saving of £491 (described as a combined net benefit in the BSIL tool). By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are discounted at 3.5%","Benefits to the child: Lifetime. Benefits to the mother: up to 10 years after birth.","-","Intervention cost and QALYs gained by the mother and child. ICER","England",3.5000000000000003E-2,"£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Norman et al., 2010)",2019]
["L27","Mental Health","Postnatal Depression","Booklet on Postnatal Depression (PND)","No","-",147,"-","This intervention has been taken from PHE's Best Start in Life Tool. An educational booklet is provided 4 weeks after birth which explains the symptoms of PND and identifies local services. The intervention has an ICER of £147.","Cost-Utility Analysis","Published PHE ROI tool","256 women at low risk of postnatal depression, 4 weeks after birth.","Usual Care","This intervention results in 0.0076 QALYs gained per person with an overall cost of £1.12 per person, which results in an ICER of £147. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted.","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Sealy et al., 2009)",2019]
["L28","Mental Health","Postnatal Depression","Early Contact with Care Provider","No","-",7365,"-","This intervention has been taken from PHE's Best Start in Life Tool. Early contact involves a postnatal check-up with a GP, 1 week after hospital discharge. This intervention has an ICER of £7,365.","Cost-Utility Analysis","Published PHE ROI tool","Women giving birth, to infants of 37 or more weeks gestation, at one rural and one metropolitan hospital between February and December 1995 inclusive","Usual Care","This intervention results in 0.0058 QALYs gained per person with an overall cost of £42.72 per person, which results in an ICER of £7,365. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted.","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Gunn et al., 1998)",2019]
["L29","Mental Health","Postnatal Depression","Calcium Prescription","No","-",9566,"-","This intervention has been taken from PHE's Best Start in Life Tool. Women are prescribed 1000mg of elemental calcium, twice a day (2000mg in total) between 11 and 21 weeks' gestation until birth. This intervention has an ICER of £9,566.","Cost-Utility Analysis","Published PHE ROI tool","Women between 11 and 21 weeks gestation who had never previously given birth.","Usual Care","This intervention results in 0.0086 QALYs gained per person with an overall cost of £82.27 per person, which results in an ICER of 9,566. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted. ","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Harrison-Hohner et al., 2001)",2019]
["L30","Mental Health","Postnatal Depression","Cognitive Behavioural Therapy (CBT) based Intervention","No","-",41258,"-","This intervention has been taken from PHE's Best Start in Life Tool. CBT involves a 1 hour prevention session between 2 and 5 days postnatally. This intervention results in an ICER of £41,258.","Cost-Utility Analysis","Published PHE ROI tool","Selective: women with a score of 9 or more on the Social Disadvantage Screening Index.","Usual Care"," This intervention results in 0.0025 QALYs gained per person with an overall cost of £103.14, which produces an ICER of 41,258. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted..","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Barnes et al., 2009)",2019]
["L31","Mental Health","Postnatal Depression","Education on Preparing for Parenting","No","-",17551,"-","This intervention has been taken from PHE's Best Start in Life Tool. A midwife advisor for twins provides a series of education sessions, additional home visits and attendance at an antenatal clinic for women with twins. This intervention results in an ICER of £17,551.","Cost-Utility Analysis","Published PHE ROI tool","Selective: Women with twins","Usual Care"," The interventions results in 0.0158 QALYs gained per person with an overall cost of £277.31 per person, which produces an ICER of 17,551. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted.","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Sen, 2006, Zlotnik et al., 2001) ",2019]
["L32","Mental Health","Postnatal Depression","Interpersonal Therapy (IPT) based Intervention.","No","-",35083,"-","This intervention has been taken from PHE's Best Start in Life Tool. IPT involves 5 individual 1-hour sessions and results in an ICER of £35,083.","Cost-Utility Analysis","Published PHE ROI tool","Selective: Mothers at risk of post-natal depression determined by the Edinburgh Postnatal Depression Scale.","Usual Care","This intervention results in 0.0147 QALYs gained person with an overall cost of £515.72 per person, which produces an ICER of 35,083. By default, only 10% of the population of interest are allocated to the intervention, this can be varied/defined by the end user. The value of a QALY is £60,000. Costs and health benefits/QALYs are not discounted. ","Benefits (QALYs) to the mother: 1 year.","-","Intervention cost and QALYs gained by the mother. ICER","England","Not Discounted","£ GBP",2018,"PHE Best Start in Life ROI tool","Link to Source","Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, Harvey R, Bessey A, Cantrell A, Dennis CL, Ren S. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technology Assessment. 2016;20(37). (Chabrol et al., 2002)",2019]
["L33","Mental Health","Treatment for Depression","Telemedicine for depression","No","€1.45 to € 1.76","-","-","Telemedicine for depression is a preventative intervention which provides psychological self-help resources over the Internet with/without support from a therapist. This intervention provides a return of €1.76 for every €1 invested (BCR).","Cost-benefit analysis","Published Academic Journal","Adults aged 18-65 in the Netherlands","Enhanced Usual Care - in alignment with Dutch clinical guidelines for treatment of depression","The BCR is described as an ROI in the original paper. The benefits/ health gains in terms of lower disease burden are calculated as a reduction in DALYs and the costs are direct medical costs only. DALYs can be reduced by primary prevention of depression and secondly by treating depression which lowers its disease burden. The value of a DALY is €20,000. The model in this intervention, DEPMOD, is relevant to depressive disorder defined by the DSM-IV. It is assumed the total population is 10 million, aged 18-65 years.","5 years","-","DALYs\nBenefit-Cost Ratio","Netherlands","1.5% for Effects\n4.0% for costs","€ EUR 2009",2014,"Lokkerbol J, Adema D, Cuijpers P, et al. Improving the cost-effectiveness of\na healthcare system for depressive disorders by implementing telemedicine:\na health economic modelling study. Am J Geriatr Psychiatry 2014;22:253–62.","Link to Source","-",2019]
["L34","Mental Health","Reducing the stigma of mental illness","Antistigma social marketing campaign","No","0.7 to 1.9","-","-","This study is an economic analysis of The Time to Change (TTC) campaign and it estimates the impact of reducing stigma / discrimination on the uptake/use of mental health services. The model assumes that due to stigma some people will not seek medical help and will have lower employment opportunities because of their condition and discrimination from potential employers. By reducing the stigma associated with mental illness, this intervention provides health gains for affected individuals. The benefits for people aged 25-44 years are £1,342,305 and the cost ranges from £725,000 to £2,000,000 which results in a BCR of 0.7 to 1.9 for each £1 invested. ","Cost-benefit analysis","Published Academic Journal","Adults resident in England, aged 25-44, in middle-income socioeconomic groups","No Intervention","The BCR is described as an ROI in the original paper. Without the intervention, 50% of people do not access mental health services but with the intervention (TTC Campaign) 49% do not access services, meaning a success rate of 1%. \nNo discounting was applied.","1 year","-","ROI/BCR\nHealth Gains in Financial terms for affected individuals.\nCampaign Costs","England","None","£ GBP",2013,"Evans-Lacko S, Henderson C, Thornicroft G, et al. Economic evaluation of the\nanti-sigma social marketing campaign in England 2009-2011. Br J Psychiatry\n2013;55:95–101.","Link to Source","-",2019]
["L35","Mental Health","Perinatal Health","Improving perinatal mental health services","No","£3.98 : £1",null,null,"This intervention aims for every women to be able to access evidence-based specialist mental health advice, support and treatment during the perinatal period.\nSeek to ensure that every footprint establishes a comprehensive perinatal pathway with four key components:\n\n1. Access to mental health advice and support embedded within universal maternity, health visiting and GP services\n2. Routinely asking about mental health in all consultations with pregnant women and up to one year after childbirth\n3. Rapid access to psychological therapies for all women who will benefit\n4. Clear pathways including support during and after childbirth, specialist perinatal community teams, parent-infant services, and appropriate access to mother and baby units\n","-","London School of Economics economic case","-","No intervention","Net savings observed from 2 - 5 years \n\nTotal costs of the intervention to the NHS are £407 per birth p.a.\nPer birth costs for each component being:\n\na) £205 for training and specialist supervision\nb) £18 mental health assessments\nc) £184 specialist psychological and clinical support and networks","2 - 5 years","NHS","NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","-",2019]
["L36","Mental Health","Stop Smoking services and interventions","Smoke free mental health trusts and quitting support","No",null,null,"c£1,460 p.a. per person to the health and care system on average over 10 years\n\nc£1,890 p.a. over 10 years to the NHS\n\nc-£430 (net cost) to local authorities ","This intervention aims to reduce smoking related ill-health for patients of mental health trusts and their staff.\n\nThe intervention aims to do this by:\n\n1. Enforcing smoke free buildings and ground\n2. Providing a mix of very brief advice and intensive interventions training to all staff\n3. Consistently recording smoking status\n4. Offering stop smoking support to all people who smoke\n\nPHE estimates that 95% of patients could be screened and 95% of those who are smokers could be given appropriate help to quit. It is estimated the long-term quit rate for long term patients is 40%, and 25% for short-term patients.","-","Primary PHE modelling","-","No intervention","Net savings over 10 years\n\nPHE estimates that the intervention could cost c£1,430 p.a. to the health and care system on average over 10 years. The average cost per person to the NHS is c£790 p.a. over 10 years, and c£640 to local authorities. This includes nicotine replacement therapy, one off set up cost and training and estate costs (e.g. activities to replace smoking).","10 years","Health and care system\n\nNHS\n\nLocal authorities","NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","Sohal H, Huddlestone L, Ratschen E. Preparing for Completely Smoke-Free Mental Health Settings: Findings on Patient Smoking, Resources Spent Facilitating Smoking Breaks, and the Role of Smoking in Reported Incidents from a Large Mental Health Trust in England. International journal of environmental research and public health [Internet]. 2016 Feb 25; 13(3).",2019]
["M1","MSK and Falls","Falls Prevention","Otago strength and balance exercise","No","Financial £0.95 : £1\n\nSocietal £2.20 : £1","-","-","The Otago programme is a home based exercise programme in which participants are encouraged to perform exercises three times a week at home and also walk indoors and outdoors at a moderate pace. Otago is recommended for at least one year and participants receive support from trained staff through home visits and follow up telephone calls.  \n","ROI tool","ROI tool","65 - 97 year olds","No intervention","Value of a QALY - £60,000\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\n","2 years","NHS  \nLocal authority","Total falls\nGP visits\nNHS and LA cost savings\nQALY gains for service users","England","3.5% - costs\n1.5% - benefits","£ GBP",2018,"PHE Falls prevention ROI tool","https://www.gov.uk/government/publications/falls-prevention-cost-effective-commissioning","Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc. 2002;50(5):905-11.",2019]
["M2","MSK and Falls","Falls Prevention","Falls Management exercise (FaME)","No","Financial £0.99 : £1.\n\nSocietal £2:28 : £1","-","-","The Falls Management Exercise (FaME) programme is a community based group programme delivered by a postural stability instructor (PSI). The programme consists of weekly classes lasting between 45 and 75 minutes with additional home exercises.   \n","ROI tool","ROI tool","65 - 94 year olds","No intervention","Value of a QALY - £60,000\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\n","2 years","NHS\nLocal authority","Total falls\nGP visits\nNHS and LA cost savings\nQALY gains for service users","England","3.5% - costs\n1.5% - benefits","£ GBP",2018,"PHE Falls prevention ROI tool","https://www.gov.uk/government/publications/falls-prevention-cost-effective-commissioning","liffe S, Kendrick D, Morris R, Masud T, Gage H, Skelton D, et al. Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care. Health Technology Assessment. 2014;18(8):1-106.",2019]
["M3","MSK and Falls","Falls Prevention","Tai Chi or Tai Ji Quan","No","Financial £0.85 : £1\n\nSocietal £1.97 : £1","-","-","Tai chi exercises combine deep breathing and relaxation with flowing movement. It can be performed in a community based group on a weekly basis, with additional exercises at home. Tai Chi should be considered as a type of physical activity rather than a clinical falls prevention intervention.","ROI tool","ROI tool","69 - 90 years old","No intervention","Value of a QALY - £60,000\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\n","2 years","NHS  \nLocal authority","Total falls\nGP visits\nNHS and LA cost savings\nQALY gains for service users","England","3.5% - costs\n1.5% - benefits","£ GBP",2018,"PHE Falls prevention ROI tool","https://www.gov.uk/government/publications/falls-prevention-cost-effective-commissioning","Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.",2019]
["M4","MSK and Falls","Falls Prevention","Home Assessment and Modification","No","Financial £3.17 : £1\n\nSocietal £7.34 : £1.","-","-","Home assessment and modification (HAM) is a service in which relevant experts risk assess a person’s usual residence to identify environmental hazards and carries out actions to reduce these. Typical environmental hazards are loose mats, poor lighting and no handrails.","ROI tool","ROI tool","62 - 91 years old","No intervention","Value of a QALY - £60,000\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\n","2 years","NHS  \nLocal authority","Total falls\nGP visits\nNHS and LA cost savings\nQALY gains for service users","England","3.5% - costs\n1.5% - benefits","£ GBP",2018,"PHE Falls prevention ROI tool","https://www.gov.uk/government/publications/falls-prevention-cost-effective-commissioning","Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.",2019]
["M5","MSK and Falls","MSK","Cognitive behavioural therapy (CBT) including exercise - lower back pain","No","Financial ROI £0.11 : £1\n\nSocietal ROI £7.52 : £1","-","-","Intervention for the treatment of LBP which comprised exercise and education using CBT.  The intervention was delivered as group sessions by physiotherapists specifically trained in CBT.  Eight two-hour sessions delivered over a five week period in groups of four to 10 led by two physiotherapists.  An information booklet was also provided.","ROI tool","ROI tool","18 - 65 years old who consulted their GPs with persistent disabling LBP","No intervention","Value of a QALY - £60,000\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\nBased on a population sample of 1,000","15 months","NHS  \nLocal authority","Health care savings\n\nQALY gains\n\nImprovement in Roland Morris Disability Questionnaire Score\n","England","3.5% - costs\n1.5% - benefits","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","https://www.ncbi.nlm.nih.gov/pubmed/17621203",2019]
["M6","MSK and Falls","MSK","STarT Back (stratified risk assessment and care) - lower back pain","No","Financial ROI £10.58 : £1\n\nSocietal ROI (excl. productivity) £90.91 : £1\n\nSocietal ROI (incl. productivity) £226.23 : £1","-","-","Uses a validated, simple-to-use prognostic screening method (the Keele STarT Back Screening Tool) to allocate patients into one of three risk-defined groups—low, medium, and high .  Three treatment pathways were matched to these risk groups. \n","ROI tool","ROI tool","Adults over 18 years with back pain of any duration with or without associated radiculopathy","No intervention","Value of a QALY - £60,000\nIncluding productivity benefits for societal ROI\nBased on a population sample of 1,000","12 months","NHS  \nLocal authority","Health care savings\n\nQALY gains\n\nDays of worked saved","England","Not applicable for 1 year intervention","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","http://www.wmahsn.org/programmes/view/start-back-",2019]
["M7","MSK and Falls","MSK","PhysioDirect - Early telephone assessment and advice - all MSK conditions","No","Financial ROI £2.08 : £1\n\nSocietal ROI  £47.32 : £1","-","-","PhysioDirect involved telephone assessment and advice followed by face-to-face care if required (as opposed to being placed on a waiting list for routine face-to-face treatment).  The interview was conducted by a specially trained senior physiotherapist and assisted by computerised templates.  Patients were sent leaflets and advice on self-management, with invitation to call again or make a face to face appointment.\n","ROI tool","ROI tool","Adults 18+ referred by their general practitioner or self-referred for physiotherapy","No intervention","Value of a QALY - £60,000\n\nBased on a population sample of 1,000","6 months","NHS  \nLocal authority","Health care savings\n\nQALY gains","England","Not applicable for 1 year intervention","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","http://www.csp.org.uk/frontline/article/hanging-telephone",2019]
["M8","MSK and Falls","MSK","Self-referral to physiotherapy - all MSK conditions","No","Financial ROI £98.54 : £1\n","-","-","Patients could either undertake self-referral to a physiotherapist, with or without the suggestion of their GP.","ROI tool","ROI tool","Adults","No intervention","\nBased on a population sample of 1,000","12 months","NHS  \nLocal authority","Health care savings\n","England","Not applicable for 1 year intervention","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","http://www.csp.org.uk/professional-union/practice/self-referral-key-improving-access-physiotherapy",2019]
["M9","MSK and Falls","MSK","Yoga for Healthy Lower Backs","No","Financial ROI £-0.98 : £1\n\nSocietal ROI (excl. productivity) £6.61 : £1\n\nSocietal ROI (incl. productivity)  £10:17 : £1","-","-","Participants received a 12 week course of yoga (75 min weekly class) plus a relaxation CD, student yoga manual, yoga mat, the Back Book, education booklet for improving back pain and usual care.  ","ROI tool","ROI tool","18 - 60 year old patients with lower back pain","No intervention","Value of a QALY - £60,000\nIncluding productivity benefits for societal ROI\nBased on a population sample of 1,000","12 months","NHS  \nLocal authority","Health care savings\n\nQALY gains\n\nDays of worked saved\n\nImprovement in Roland Morris Disability Questionnaire Score","England","Not applicable for 1 year intervention","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","http://www.escape-pain.org/",2019]
["M10","MSK and Falls","MSK","ESCAPE-Pain for knee pain","No","Financial ROI £5.20 : £1\n","-","-","Exercise-based rehabilitation program designed to improve function by integrating exercise, education, and self-management strategies to dispel inappropriate health beliefs, alter behaviour, and encourage regular physical activity. Participants were invited to attend 12 supervised sessions twice weekly for 6 weeks., either individually or in small groups. After completion, participants were discharged with encouragement to perform home exercises and physical activity.","ROI tool","ROI tool","50+ reporting knee pain for at least six months. Patients had to have had no physio in previous 12 months and not be wheelchair bound","No intervention","\nCosts are discounted at 3.5%\nQALYs are discounted at 1.5%\nBased on a population sample of 1,000","30 months","NHS  \nLocal authority","Health care savings\n\nImprovement in WOMAC score","England","3.5% - costs\n1.5% - benefits","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","http://www.yogaforbacks.co.uk/",2019]
["M11","MSK and Falls","MSK","Vocational advice from physiotherapists in primary care - MSK pain causing employment issues","No","Societal ROI (incl. productivity) £11.14 : £1","-","-","A vocational advice service to provide a structured approach to managing work related issues.  People with a MSK problem who require help and support in remaining at or returning to work may be referred to the vocational advice service by their GP or nurse practitioner.   A stepped care model is used, with initial telephone contact and follow-up face-to-face appointment for approximately 20% of patients. \n","ROI tool","ROI tool","Patients 18+, absent from or struggling at work because of MSK pain for less than 6 months","No intervention","\nIncluding productivity benefits for societal ROI\nBased on a population sample of 1,000","12 months","NHS  \nLocal authority","Days of worked saved","England","Not applicable for 1 year intervention","£ GBP",2017,"PHE MSK ROI tool","https://www.gov.uk/government/publications/musculoskeletal-conditions-return-on-investment-tool","https://www.keele.ac.uk/kctu/ourresearch/swap/",2019]
["M12","MSK and Falls","Falls Prevention","Community-based falls prevention","No","AU$20.6: $1","-","-","A cost-benefit analysis of \"Stay on Your Feet\" (SOYF) which is a community based falls prevention program, was undertaken. The benefits of the program in terms of all direct and indirect costs avoided was AU$16.9 million and the cost of the program was AU$781,829. This produced an average overall benefit-cost ratio of 20.6 :1","Cost-benefit analysis","Published Academic Journal","People aged 60 and over at all risk levels, in the North Coast Region of New South Wales, Australia. This is a approximately 90,000 people out of a total population of 400,000.","Older people in Queensland, Australia - No Intervention","The costs and benefits are recorded in AUD where 1 $AUD is 0.75 $USD. The CBA includes direct (medical) and indirect costs. Benefits are measured using two methods. Method 1 compares hospital admission rate between the two regions based on the first SOYF evaluation. Method 2 compares hospital utilisation in the intervention region compared to NSW as a whole.  The BCR of 20.6 is an average of both methods. ","18 months","-","Benefit-Cost Ratio","Australia",0.08,"1995/96 \n$ AUD",2006,"Beard J, Rowell D, Scott D, et al. Economic analysis of a community-based falls\nprevention program. J R Inst Public Health 2006;120:742–51.","Link to source","-",2019]
["M13","MSK and Falls","Falls Prevention","Establish fracture liaison services","No",null,null,"c£14p.a. per person over 5 years","This intervention aims to reduce fractures from falls.\n\nFracture liaison services (FLS) will support elderly patients at risk of fracture and reduce demand for social care provision.\n\nThis intervention will seek to achieve this by identifying people at risk of future fractures and falls and offering bone strengthening medicines and referrals to services that can reduce this risk (for example, strength and balance programmes).","Economic evaluation","Department of Health economic evaluation","In an area with a population of 320,000, a cohort of 797 patients would present with a hip, humerus, spine or forearm fracture.","No intervention","Net savings over 5 years based on year 1 cohort\n\nIt can be estimated that the cost of running an FLS in NHS trusts for a year 1 cohort of 797 patients is c£59 p.a. per person over 5 years. This includes one year costs of running the FLS (staff and scanning equipment) and five year drug costs, the majority of which are incurred in the first year.","5 years","NHS trusts","NHS savings","England","-","£ GBP",2016,"Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016.","Link to source","\nhttps://webarchive.nationalarchives.gov.uk/20130124050747/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_110099.pdf",2019]
["N1","Cardiovascular Disease Prevention","CVD","Antihypertensives without Blood Pressure Self Management","No","-","-",2944260611,"A drug used to treat high blood pressure in addition to checking your own blood pressure regularly and making changes to lifestyle risk factors e.g. weight management, exercise, reduced salt in diet.\n\nQALYs gained = 499644\n","ROI tool","ROI tool"," England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with the following CVD risk factors: hypertension, chronic kidney disease, diabetes.","Intervention at 60.2% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS\n","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","https://www.gov.uk/government/publications/cardiovascular-disease-prevention-cost-effective-commissioning",2019]
["N2","Cardiovascular Disease Prevention","CVD","Antihypertensives","No","-","-",2335048000,"A drug used to treat blood pressure\n\nQALYs gained = 523392","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention being taken up by individuals with the following CVD risk factors: hypertension, chronic kidney disease, diabetes","Intervention at 57% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Paz et al., (2016) Treatment efficacy of anti-hypertensive drugs in monotherapy or combination: ATOM systematic review and meta-analysis of randomized clinical trials according to PRISMA statement. Medicine 95(30):e4071\n\nEttehad et al., (2016) Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. The Lancet 387(10022):957-67.\n\nNICE Guideline CG127: Hypertension (2011) The clinical management of primary hypertension in adults\n\nAdarkwah et al., (2013) To treat or not to treat? Cost-effectiveness of ACE inhibitors in non-diabetic advanced renal disease - a Dutch perspective. Kidney Blood Press Res37(2-3):168-80.",2019]
["N3","Cardiovascular Disease Prevention","CVD","Statins","No","-","-",2138031981,"Any group of drugs which help to reduce cholesterol in the blood\n\nQALYs gained =390579","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention being taken up by individuals with the following CVD risk factors: Qrisk >= 10%, familial hypercholesterolemia, type I diabetes, chronic kidney disease.","Intervention at 42% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Collins et al., (2016) Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet ;388(10059): 2532-61.\n\nErqou et al., (2014) Statins and glycaemic control in individuals with diabetes: a systematic review and meta-analysis. Diabetologia 57(12):2444-52\n\nNICE Guideline CG181: Lipid modification (2014); Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease",2019]
["N4","Cardiovascular Disease Prevention","CVD","Annual Review","No","-","-",1239313913,"Annual review which includes medication review and diagnosis of comorbid conditions. Patients are eligible to have the intervention every year following diagnosis of one or more high risk conditions.\n\nQALYs gained  = 529734","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with the following CVD risk factors: familial hypercholesterolemia, hypertension, atrial fibrillation, chronic kidney disease, diabetes, non-diabetic hyperglycaemia.","Intervention at 44% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Elliott et al., (2016) Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmatic randomised controlled trial of the New Medicine Service. BMJ Qual Saf 25:747-758",2019]
["N5","Cardiovascular Disease Prevention","CVD","NHS Health Check","No","-","-",463131890,"A health check-up for adults in England aged 40-74. It's designed to spot early signs of stroke, kidney disease, heart disease, type 2 diabetes or dementia\n\nQALYs gained = 222252","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention, with the intervention taken up by individuals aged 40-75 with no diagnosed risk factors.","Intervention at 44% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","Local authorities","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Chang et al., (2016) Impact of the National Health Service Health Check on cardiovascular disease risk: a difference-in-differences matching analysis. Cmaj 188(10):E228-38.",2019]
["N6","Cardiovascular Disease Prevention","CVD","NHS DPP","No","-","-",5345406,"A joint commitment from NHS England, Public Health England and Diabetes UK. The intervention identifies those at high risk and refers them onto a behaviour change programme\n\nQALYs gained = 10164","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention being taken up by individuals with the following CVD risk factors: non-diabetic hyperglycaemia.","Intervention at 35% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nCost saving evidence","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Ashra et al., (2015). A systematic review and meta-analysis assessing the effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes mellitus in routine practice. Public Health England. PHE publications gateway number: 2015280\n\nNICE Public Health Guideline PH38: Type 2 diabetes; prevention in people at high risk (2012) (update 2017)",2019]
["N7","Cardiovascular Disease Prevention","CVD","Weight Management","No","-",438,"-","Behavioural weight management programme\n\nQALYs gained = 26880","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with the following CVD risk factors: familial hypercholesterolemia, hypertension, atrial fibrillation, chronic kidney disease, diabetes, non-diabetic hyperglycaemia.","Intervention at 13% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","Local authorities","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Hartmann-Boyce et al., (2014) Effect of behavioural techniques and delivery mode on effectiveness of weight management: systematic review, meta-analysis and meta-regression. Obesity reviews 15(7):598-609.\n\nNICE Public Health Guideline PH53: Weight management: Lifestyle services for overweight or obese adults (2014)",2019]
["N8","Cardiovascular Disease Prevention","CVD","Nutritional Advice for CKD","No","-",1440,"-","Individualised programme of nutritional advice using a band 5 dietician \n\nQALYs gained = 12004","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with chronic kidney disease.","Intervention at 20% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nBand 5 dietician cost: £36 per hour, 6 x 30  minute fortnightly sessions\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","CCGs","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Palmer et al., (2017) Dietary interventions for adults with chronic kidney disease. Cochrane Database Syst Rev 4:CD011998\n",2019]
["N9","Cardiovascular Disease Prevention","CVD","Medicine Use Review","No","-",17794,"-","Pharmacist Medicine Review\n\nQALYs gained = 2490","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals who have been newly prescribed anticoagulants, anti-hypertensives, statins or  blood glucose lowering medication","Intervention at 65% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","CCGs","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Elliott et al., (2016) Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmatic randomised controlled trial of the New Medicine Service. BMJ Qual Saf 25:747-758\n\nElliott et al., (2017) Cost Effectiveness of Support for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies: An Economic Evaluation of the New Medicine Service (NMS) Compared with Normal Practice. Pharmacoeconomics 35(12):1237-55. ",2019]
["N10","Cardiovascular Disease Prevention","CVD","Diabetes Education","No","-",7620.0556176874798,"-","Educational programmes for type 1 diabetes and group-based educational programmes for type 2 diabetes\n\nQALYs gained = 19964","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with the following CVD risk factors: diabetes (types 1 and 2)","Intervention at 7% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","NICE Guideline NG17: Type 1 diabetes in adults; Diagnosis and management: National Institute for Health and Care Excellence, 2015\n\nOdgers-Jewell et al., (2017) Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression. Diabetic Medicine 34(8):1027-39\n\nKruger et al., (2013) The cost-effectiveness of the Dose Adjustment for Normal Eating (DAFNE) structured education programme: an update using the Sheffield Type 1 Diabetes Policy Model. Diabet Med 30(10):1236-44.\n\nGillett et al., (2010) Delivering the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cost effectiveness analysis. BMJ 341:c4093.",2019]
["N11","Cardiovascular Disease Prevention","CVD","Cascade Testing","No","-",102315.63419725097,"-","Cascade testing using DNA testing\n\nQALYs gained = 2454","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention  being taken up by individuals with undiagnosed Familial Hypercholesterolemia.","Intervention at 24% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Kerr et al., (2017) Cost effectiveness of cascade testing for familial hypercholesterolemia, based on data from familial hypercholesterolemia services in the UK. Eur Heart J 38(23):1832-39.\n\n",2019]
["N12","Cardiovascular Disease Prevention","CVD","Anticoagulants","No","-",5744.27119700602,"-","Medicine that helps prevent blood clots. Given to people at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes\n\nQALYs gained = 90771","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with atrial fibrillation.","Intervention at 76% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Guo L et al., (2017) Comparative Efficacy of Clinical Events Prevention of Five Anticoagulants in Patients With Atrial Fibrillation (A Network Meta-Analysis). Am J Cardiol 119(4):585-93.\n\nNICE Guideline CG180: Atrial Fibrillation (2014); The management of atrial fibrillation",2019]
["N13","Cardiovascular Disease Prevention","CVD","Smoking Cessation","No","-",12703.998458967862,"-","NHS stop smoking services, for smokers in all high risk groups\n\nQALYs gained = 137796","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with the following CVD risk factors: familial hypercholesterolemia, hypertension, atrial fibrillation, chronic kidney disease, diabetes, non-diabetic hyperglycaemia.","Intervention at 3% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","Local authorities","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Dobbie et al., (2015). Evaluating outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study. Health Technol Assess 19(95):1-192\n\nNICE Public Health Guideline PH10: Stop smoking services (2008) (update 2017)",2019]
["N14","Cardiovascular Disease Prevention","CVD","Blood Pressure Self Monitoring","No","-",21486.241201023713,"-","Blood pressure self-monitoring\n\nQALYs gained = 88477","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals treated with hypertensives.","Intervention at 31% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Tucker et al., (2017) Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS medicine 14(9):e1002389.\n\nKaambwa et al., (2014) Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis. European journal of preventive cardiology 21(12):1517-30.",2019]
["N15","Cardiovascular Disease Prevention","CVD","Insulin Pump","No","-",1122862.7693334019,"-","Insulin pump therapy, subcutaneous insulin infusion.\n\nQALYs gained = 2016","ROI tool","ROI tool","England\n\n The tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with diabetes.","Intervention at 15% uptake ","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Pickup et al., (2008). Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med 2008;25(7):765-74.\n\nCummins et al., (2010) Clinical effectiveness and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes: systematic review and economic evaluation. Health Technol Assess 14(11):iii-iv, xi-xvi, 1-181. ",2019]
["N16","Cardiovascular Disease Prevention","CVD","Blood Glucose Lowering Therapy","No","-",38873.629154252296,"-","Blood glucose lowering medication\n\nQALYs gained = 158375","ROI tool","ROI tool","England\n\nThe tool looks only at secondary prevention of CVD, with the intervention taken up by individuals with type 1 diabetes.","Intervention at 71% uptake","Value of QALY £60,000\nCosts discounted at 3.5%\nQALYs discounted at 1.5%\n\nFigures assume 100% uptake by eligible population. Figures based on different assumptions about uptake are available to users through the tool","20 years","NHS","NHS and social care savings\n\nQALY gains\n\nICER","England","3.5% costs\n1.5% QALYs","£ GBP",2018,"PHE CVD ROI tool","https://cvd-prevention.shef.ac.uk","Clarke et al., (2004) A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68). Diabetologia 47(10):1747-59\n\nNICE Guideline NG28: Type 2 diabetes in adults; Management (2015) ",2019]
["O1","Miscellaneous","Road Safety","20 mph zones in London","No","£2.19-£0.66 : 1","-","Cost per QALY was £429,800 in low casualty areas and £86,500 in high casualty areas.","Investing £1 in mandatory 20 mph speed limit zones produces a BCR of 0.66 in low casualty areas and a BCR of 2.19 in high casualty areas.","Cost-benefit analysis","Published Academic Journal","Population of London, UK","Background reduction in causalities in low and high casualty areas without mandatory 20 mph speed limits i.e. no intervention","In low casualty areas, the total costs of casualties were £120,749 where the intervention was implemented compared to £170,445 for the control, this resulted in a saving/benefit of £49,700 in terms of reduced casualties. The cost of the intervention was £75,100 which produced a BCR of 0.66. In high casualty areas, the total costs of casualties were £350,375 where the intervention was implemented compared to £516,780 for the control, this resulted in a saving/benefit of £166,400 in terms of reduced casualties. The cost of the intervention was £75,800 which produced a BCR of 2.19. \nThe cost-benefit analysis was conducted from a societal perspective and included the investment in changing road designs and medical/human costs of casualties including lost production. The benefits of preventing casualties are based on DfT valuations. \nThe cost-utility analysis was conducted from a public sector perspective which covers the cost of health, police, local government and DfT costs. and uses QALYs as the health outcome.","10 years","-","Benefit Cost Ratio\nCasualties Averted\nICER = Cost/QALYs\n","England",3.5000000000000003E-2,"£ GBP inflated to 2009",2013,"Peters JL, Anderson R. The cost-effectiveness of mandatory 20mph zones for the\nprevention of injuries. J Public Health (Oxf ) 2013;35:40–8.","Link to source","-",2019]
["O2","Miscellaneous","Hazardous Substance Control","Lead paint control","No","$17-$221","-","-","This intervention aims to reduce children's exposure to lead and prevent associated health conditions by introducing lead hazard control. The main source of lead exposure is lead-based paint used in housing prior to 1978. The intervention provides a return of $17 to $221 for every $1 invested.","Cost-benefit analysis","Published Academic Journal","Children aged 6 and under","No Intervention","This intervention only considers exposure to lead from lead - based paint in housing - no other lead source is considered.\nThe intervention considers two control methods, the first is lead hazard screening which costs $1,200 per housing unit and the second is an inspection, risk assessment and complete removal of lead paint which is estimated to cost $10,800 per housing unit. The benefits include reduced healthcare costs, increased lifetime earnings and lower crime.","Unclear","-","Benefit-Cost Ratio","USA","None","$ USD 2006",2009,"Gould E. Childhood lead poisoning: conservative estimates of the social and\neconomic benefits of lead hazard control. Environ Health Perspect\n2009;117:1162–7.","Link to Source","-",2019]

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[null,null,null,null,null,null,null,null,null,null,null,"Theme",42,"Sexual Health, Reproductive Health and HIV",{"$f":"LEN(N8)","v":42},null,null,"Secondary"]
[null,null,null,null,null,null,null,null,null,null,null,"Activity",74,"Contraception",{"$f":"LEN(N9)","v":13},null,null,"Secondary"]
[null,null,null,null,null,null,null,null,null,null,null,"Intervention",119,"Contraception",{"$f":"LEN(N10)","v":13}]
[null,null,null,null,null,null,null,null,null,null,null,"For output",3,"Yes",{"$f":"LEN(N11)","v":3}]
[null,null,null,null,null,null,null,null,null,null,null,"Benefit-cost ratio (BCR)",24,null,{"$f":"LEN(N12)","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,"ICER",57,4965,{"$f":"LEN(N13)","v":4}]
[null,null,null,null,null,null,null,null,null,null,null,"Cost saving evidence",41,null,0]
[null,null,null,null,null,null,null,null,null,null,null,"Summary of evidence",866,"School based group education for increasing rates of condom use and reducing STIs and unwanted pregnancy.\nThe intervention involved weekly lessons following a health curriculum that highlights the impacts of drug and alcohol\nuse, violence and sexual behaviour on health. The curriculum was developed throughout with input from students,\nteachers and parents. Teaching staff were trained to deliver the program.",{"$f":"LEN(N15)","v":410}]
[{"$f":"Summary_input","v":"School based group education for increasing rates of condom use and reducing STIs and unwanted pregnancy.\nThe intervention involved weekly lessons following a health curriculum that highlights the impacts of drug and alcohol\nuse, violence and sexual behaviour on health. The curriculum was developed throughout with input from students,\nteachers and parents. Teaching staff were trained to deliver the program."},null,null,null,null,null,null,null,null,null,null,"Type of analysis",44,"Cost-utility analysis",21]
[null,null,null,null,null,null,null,null,null,null,null,"Type of evidence",54,"Published report",16]
[null,null,null,null,null,null,null,null,null,null,null,"Study population",133,"Sexually active 11-16 year olds.",32]
[null,null,null,null,null,null,null,null,null,null,null,"Comparator",82,"No intervention",15]
[null,null,null,null,null,null,null,null,null,null,null,"Assumptions / Caveats",1133,"Cost: £157.15 per person.Reference rated the quality of evidence as low.\nOutcomes: 9.36% increase in use of condoms, which provided an additional 0.156 QALYs and £934 cost savings from reduced transmission of chlamydia and associated complications, such as pelvic inflammatory disease [PID] and ectopic pregnancy). Benefits are assumed to occur 5 years or more after intervention.",380]
[null,null,null,null,null,null,null,null,null,null,null,"Timeframe",20,"7 years",7]
[null,null,null,null,null,null,null,null,null,null,null,"Who pays?",19,"LA",2]
[null,null,null,null,null,null,null,null,null,null,null,"Measured benefit of evidence?",110,"QALY gains for service users, NHS savings",41]
[null,null,null,null,null,null,null,null,null,null,null,"Country ",21,"England",7]
[null,null,null,null,null,null,null,null,null,null,null,"Discount Rate",25,3.5000000000000003E-2,5]
[null,null,null,null,null,null,null,null,null,null,null,"Currency",13,"£ GBP 2007/08",13]
[null,null,null,null,null,null,null,null,null,null,null,"Publication Year",4,2009,4]
[null,null,null,null,null,null,null,null,null,null,null,"Reference to original source",356,"Matrix Insight. Prioritising investments in preventative health. 2009.",70]
[null,null,null,null,null,null,null,null,null,null,null,"Link to reference",38,"Link to source",14]
[null,null,null,null,null,null,null,null,null,null,null,"Further information",156,null,0]
[null,null,null,null,null,null,null,null,null,null,null,"Further information2",47,"https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwijsoe018bSAhUnDcAKHc1aDRoQFggkMAA&url=http%3A%2F%2Fhelp.matrixknowledge.com%2Ffile.axd%3Ffile%3DHE_final_report.pdf&usg=AFQjCNEhdugeQz9ULFmKI6ST2BQaCnOlaQ",246]
[null,null,null,null,null,null,null,null,null,null,null,"Further information3",108,"http://help.matrixknowledge.com/interventions/",46]
[null,null,null,null,null,null,null,null,null,null,null,"Hyperlink address",246,null,0]
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[null,null,null,null,null,null,null,null,null,null,null,"info on status (to be deleted)",554,null,{"$f":"LEN(N35)","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,"Endnote Referencing",543,"https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/jpubhealth/18/2/10.1093/oxfordjournals.pubmed.a024479/2/18-2-189.pdf?Expires=1493393740&Signature=fXT6Q0Ih3AChE1hgkaGAcs0M2C1Cclu9afCqlz3U1~HjswTbhpuPswePr3u~p2aLyVsKTQqUbQaOyTYYKirJLE1ki9tZ3VD0pRPXm7wRmcnHY9dhtqcffZfo-ai1FU9D8Q4vuh-dN5K0f8DAMXxRbtuv67YuaBuBvXPsAs4ngPXvDXt1NHgCijjEIwCTGY36W-yT~r2Y~bcHj5-WqouqGSPAOr1My2zrlvE4IzCOKyJQDpn3yLQz8gW9kqdRqzwc5IstfvEURUxhfB3ckw-Ta4l0BeEyc2V-bSblclWyo3VN-Anhm0gQSXqFNsp2t-Cee6GYX64faD6ZWdxj4009Jw__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q",{"$f":"LEN(N36)","v":543}]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,{"$f":"TODAY()","v":"2019-07-17"}]

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[]
[]
[null,null,null,null,"Health Economics Evidence Resource"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"v2.0"]
[]
[]
[]
[]
[null,null,null,null,"Further Information"]
[null,null,null,null,"Objectives of the HEER"]
[null,null,null,null,"The HEER was developed by Public Health England in order to:"]
[null,null,null,null,"  • provide a publicly available resource where economic evidence is collated and summarised"]
[null,null,null,null,"  • ensure everyone has access to accurate, clear and consistent economic advice"]
[null,null,null,null,"  • improve the accessibility of economic evidence, so that you can explore information and compare key differences across interventions"]
[]
[null,null,null,null,"Methodology for selecting sources and quality assuring evidence"]
[null,null,null,null,"The evidence in the HEER has largely been drawn from a small number of secondary sources. Secondary sources look to collect and summarise original research, also known as primary"]
[null,null,null,null,"research. In addition, some sources of evidence were also identified through conversations with researchers familiar with that topic area. ",null,null,null,null,null,null,null,null,null,null,"Sources"]
[]
[null,null,null,null,"The HEER looks to present the best available evidence on interventions. In order to do this the HEER only contains evidence that:"]
[null,null,null,null,"  • was published in the last 5 years (excluding one source) for the primary reviews - the orginal sources of the studies included in those reviews are from 1995"]
[null,null,null,null,"  • is widely referenced in public health research"]
[null,null,null,null,"  • has been quality assured by the PHE Health Economics team for accuracy"]
[null,null,null,null,"  • has been quality assured by the PHE policy teams to confirm it is consistent with current knowledge in that area"]
[]
[null,null,null,null,"In addition, the whole HEER has been reviewed by external academics to check the quality of the final product."]
[]
[null,null,null,null,"Future plans to update the HEER"]
[null,null,null,null,"The HEER will be reviewed annually to keep the information up-to-date. The next planned review will take place in September 2019. Each review will be carried out following the same rules as those used when the HEER was created. The new evidence will be clearly identified."]
[]
[null,null,null,null,"Users can contribute ideas towards how HEER should be updated by using the ‘email us’ option."]
[]
[null,null,null,null,"Factors to consider when interpreting the evidence"]
[null,null,null,null,"You should use some caution when looking to apply the evidence in the HEER to your local area. To make informed decisions you should consider:"]
[null,null,null,null,"  • the location of the studies"]
[null,null,null,null,"  • the target population"]
[null,null,null,null,"  • what costs and benefits are included"]
[null,null,null,null,"  • how costs and benefits are discounted, or reduced in value, across time"]
[null,null,null,null,"  • how long the intervention lasted"]
[null,null,null,null,"  • how long was the intervention evaluated for"]
[null,null,null,null,"  • whether the delivery setting of an intervention is the same as it was when the original research was published"]
[]
[null,null,null,null,"All of these factors can contribute to whether an intervention applied locally will match the cost-effectiveness result presented in the HEER."]
[]
[null,null,null,null,"Some NICE studies found a range of cost-effectiveness estimates. This was used to show that the intervention can be either cost-effective or not cost-effective, depending on the assumptions used. In these cases you should consider how the situation you are interested in compares to that in the evidence."]
[]
[null,null,null,null,"When looking to make comparisons, you should consider whether the interventions under consideration are similar across all of the criteria above."]
[]
[null,null,null,null,"Explanation of term \"Under Review\" in HEER"]
[null,null,null,null,"In the HEER, if a piece of evidence is \"Under Review\" it means that that PHE is currently reviewing it to make sure it is accurate and of high quality. It has still been included as it provides a helpful summary of latest available evidence. Additional care should be used for these interventions."]
[]
[null,null,null,null,"Information on development of NICE guidance"]
[null,null,null,null,"NICE reviews economic evidence by:"]
[null,null,null,null,"  • conducting a systematic review of the cost-effectiveness evidence in a particular areas of health"]
[null,null,null,null,"  • combining information sources on effectiveness, costs and benefits to estimate the cost-effectiveness of an intervention"]
[null,null,null,null,"If you would like more information on NICE’s processes, please see",null,null,null,null,null,"NICE's methods guide"]
[]
[null,null,null,null,"Information on how to develop the HEER"]
[null,null,null,null,"The HEER does not contain all information on all interventions. You may wish to contribute to the understanding of how cost-effective some interventions are by conducting an "]
[null,null,null,null,"evaluation of your own. If you are planning to undertake an evaluation of a service we recommend you look at the guidance provided in the",null,null,null,null,null,null,null,null,null,null,"government's magenta Book"]
[]
[]
[null,null,null,null," "]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"v2.0"]
[]
[]
[]
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[null,null,null,null," Glossary of terms"]
[null,null,null,null," Comparator",null,null,null,"The standard (for example, another intervention or usual care) against which an intervention is compared in a study. The comparator can be"]
[null,null,null,null,null,null,null,null,"no intervention."]
[]
[null,null,null,null," Cost-benefit analysis (CBA)",null,null,null,"A form of economic evaluation that weighs the total expected costs against the total expected benefits by valuing both in monetary terms"]
[null,null,null,null,null,null,null,null,"(for example, pounds sterling) to assess whether the benefits exceed the costs. It is measured using the benefit-cost ratio (BCR), which is the ratio"]
[null,null,null,null,null,null,null,null,"of benefits relative to costs (benefits/costs). "]
[]
[null,null,null,null," Cost-effectiveness",null,null,null,"The HEER defines an intervention as cost-effective if it is below the NICE cost per QALY threshold of £20,000. "]
[]
[null,null,null,null," Cost-effectiveness analysis (CEA)",null,null,null,"Cost-effectiveness analysis (CEA) compares the relative costs and outcomes (effects) of two or more courses of action. The benefits are"]
[null,null,null,null,null,null,null,null,"expressed in non-monetary terms related to health, such as symptom-free days or heart attacks avoided. "]
[]
[null,null,null,null,"Cost-utility analysis (CUA)",null,null,null,"The most common approach to assess cost-effectiveness is to use cost-utility analysis (often interchanged with CEA), where the benefits "]
[null,null,null,null,null,null,null,null,"are assessed in terms of both quality and duration of life, and expressed as quality-adjusted life years (QALYs) or disability-adjusted life years"]
[null,null,null,null,null,null,null,null,"(DALYs). Utility refers to the measure of the preference or value that an individual or society places upon a particular health state."]
[]
[null,null,null,null," Cost saving",null,null,null,"An intervention is considered cost-saving when the monetary benefits of an intervention are greater than its costs. Monetary savings may not"]
[null,null,null,null,null,null,null,null,"necessarily accrue as cash-releasing savings, for example due to reallocation of resources such as staffing."]
[]
[null,null,null,null," Disability adjusted life year (DALY)",null,null,null,"A measure for the overall disease burden. It is designed to quantify the impact of premature death and disability on a population by"]
[null,null,null,null,null,null,null,null,"combining them into a single, comparable measure."]
[]
[null,null,null,null," Discount rate",null,null,null,"A technique used to convert costs and benefits that occur in different time periods to 'present values', so that they can be compared. Since "]
[null,null,null,null,null,null,null,null,"costs and benefits occurring in the future are generally considered less valuable than those occurring in the present, a discount rate is applied to "]
[null,null,null,null,null,null,null,null,"future benefits."]
[]
[null,null,null,null," Dominance",null,null,null,"When comparing tests or treatments, an option that is both less effective and costs more is said to be 'dominated' by the alternative. An"]
[null,null,null,null,null,null,null,null,"option that is more effective and costs less is said to 'dominate' the alternative (see diagram in comment box)."]
[]
[null,null,null,null," Equity",null,null,null,"How fair the distribution of resources is within society. "]
[]
[null,null,null,null," Incremental analysis",null,null,null,"Also known as marginal analysis, it is an examination of the additional benefits of an activity compared to the additional costs incurred by"]
[null,null,null,null,null,null,null,null,"that same activity."]
[]
[null,null,null,null," Incremental cost-effectiveness ratio (ICER)",null,null,null,"The difference in the change in mean costs in the population of interest divided by the difference in the change in mean outcomes in the"]
[null,null,null,null,null,null,null,null,"population of interest.  It provides the 'extra cost per extra unit of outcome', which can be compared to other interventions."]
[]
[null,null,null,null," Net present value (NPV)",null,null,null,"The present value of an investment's future net benefits minus net costs."]
[]
[null,null,null,null," Productivity gains",null,null,null,"Productivity gains are the impact of an intervention on production in the economy."]
[]
[null,null,null,null," Quality adjusted life year (QALY)",null,null,null,"A measure of the state of health of a person or group in which the benefits, in terms of length of life, are adjusted to reflect the quality of life."]
[null,null,null,null,null,null,null,null,"One QALY is equal to 1 year of life in perfect health. QALYs are calculated by estimating the years of life remaining for a patient following a"]
[null,null,null,null,null,null,null,null,"particular treatment or intervention and weighting each year with a quality of life score (on a 0-1 scale)."]
[]
[null,null,null,null," Quasi-experiment",null,null,null,"Quasi-experiments contain a naturally occurring independent variable. However, in a quasi-experiment the naturally occurring independent"]
[null,null,null,null,null,null,null,null,"variable is a difference between people that already exists (i.e. age or gender). The researcher examines the effect of this variable on the"]
[null,null,null,null,null,null,null,null,"dependent variable."]
[]
[null,null,null,null," Randomised controlled trial (RCT)",null,null,null,"A study in which a number of similar people are randomly assigned to two (or more) groups to test a specific drug, treatment or other"]
[null,null,null,null,null,null,null,null,"intervention. One group (the experimental group) has the intervention being tested; the other (the comparison or control group) has an"]
[null,null,null,null,null,null,null,null,"alternative intervention, a dummy intervention (placebo) or no intervention at all. "]
[]
[null,null,null,null," Return on investment (ROI)",null,null,null,"A general term encompassing the techniques for comparing the costs and benefits generated by an investment. The HEER uses the"]
[null,null,null,null,null,null,null,null,"benefit-cost ratio as the measure of ROI."]
[]
[null,null,null,null," Sensitivity analysis",null,null,null,"A form of modelling that evaluates the impact of alternative values for some of the model parameters and other aspects of the analytical"]
[null,null,null,null,null,null,null,null,"method. It is applied particularly to the investigation of uncertainty around the values of parameter inputs."]
[]
[null,null,null,null," System model analysis",null,null,null,"A computer simulation technique that allows the user to anticipate the effect of interventions in complex situations with interdependent variables."]
[]
[null,null,null,null," Willingness to pay",null,null,null,"The maximum amount an individual is willing to pay to acquire a good or a service, or the maximum amount an individual is willing to pay"]
[null,null,null,null,null,null,null,null,"to avoid a prospective loss."]

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[]
[]
[null,null,null,null,"Health Economics Evidence Resource"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"v2.0"]
[]
[]
[]
[]
[null,null,null,null," Secondary Sources of Evidence (Phase 1 2017)"]
[]
[null,null,null,null,"1)","Harris J, Mason J, Spalding J, Knuckley S, Jones L, Perkins C, et al. A review of the cost-effectiveness of individual level behaviour change interventions. Liverpool: North West"]
[null,null,null,null,null,"Public Health Observatory. 2011."]
[null,null,null,null,"2)","Matrix Insight. Prioritising investments in preventative health. Health England. 2009."]
[null,null,null,null,"3)","McDaid D, Sassi F, Merkur S, eds. Promoting health, preventing disease: the economic case. Maidenhead: Open University Press; 2015."]
[null,null,null,null,"4)","Owen L, Morgan A, Fischer A, Ellis S, Hoy A, Kelly MP. The cost-effectiveness of public health interventions. Journal of Public Health. 2012;34(1):37-45."]
[null,null,null,null,"5)","Public Health England. A Rapid Review of Evidence on the Cost-Effectiveness of Interventions to Improve the Oral Health of Children. 2016."]
[null,null,null,null,"6)","Public Health England. A systematic review and meta-analysis assessing the effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes mellitus in"]
[null,null,null,null,null,"routine practice. 2015."]
[null,null,null,null,"7)","Public Health England. Local Health and Care Planning: Menu of preventative interventions. 2016."]
[null,null,null,null,"8)","Public Health England. The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An evidence review."]
[null,null,null,null,"9)","Public Health Wales. Making a Difference: Investing in Sustainable Health and Well-being for the People of Wales. 2016."]
[null,null,null,null,"10)","The Kings Fund, Local Government Association. Making the case for public health interventions. 2014."]
[null,null,null,null,"11)","World Health Organization. The case for investing in public health. 2014."]
[]
[]
[null,null,null,null,"About Public Health England"]
[null,null,null,null,"Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. "]
[null,null,null,null,"We do this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. "]
[null,null,null,null,"We are an executive agency of the Department of Health, and are a distinct delivery organisation with operational autonomy "]
[null,null,null,null,"to advise and support government, local authorities and the NHS in a professionally independent manner."]
[]
[null,null,null,null,"Public Health England"]
[null,null,null,null,"Wellington House"]
[null,null,null,null,"133-155 Waterloo Road"]
[null,null,null,null,"London SE1 8UG"]
[null,null,null,null,"Tel: 020 7654 8000"]
[null,null,null,null,"www.gov.uk/phe  "]
[null,null,null,null,"Twitter: @PHE_uk "]
[null,null,null,null,"Facebook: www.facebook.com/PublicHealthEngland"]
[]
[null,null,null,null,"© Crown copyright 2017"]
[null,null,null,null,"You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. "]
[null,null,null,null,"To view this licence, visit OGL or email psi@nationalarchives.gsi.gov.uk. "]
[null,null,null,null,"Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned."]
[]
[null,null,null,null,"Published March 2019"]
[null,null,null,null,"PHE publications gateway number: 2017355",null,null,null,null,"PHE supports the UN Sustainable Development Goals"]

{"sheet":"changes","index":7,"n_rows":110,"n_cols":6,"rows_kept":110,"cut":false,"hidden":true,"merged":[]}
["Date","Version","Comments","Author",null,"Actions needed"]
["2017-04-11","v13","added changes log","Rory"]
[null,null,"added notes column all sheets","Rory",null,"max reference size down to 255"]
[null,null,"moved all to data sheet","Rory",null,"max character breaks: 255, 510, 765, 1020, 1275"]
[null,null,"removed duplicate data H26","Rory"]
[null,null,"added Glossary and FAQ sheet","Rory"]
[null,"v14","harmonised some terms - cost-effectiveness, cost-saving","Rory"]
[null,null,"moved all data from notes column to further information column and removed notes column","Rory"]
[null,null,"started to create an output form - draft 0","Rory"]
[null,null,"added empty title sheet","Rory"]
[null,null,"summary and notes tabs downgraded","Rory"]
[null,null,"added empty how to use sheet","Rory"]
[null,null,"added action list for Sam+","rory"]
[null,null,"added protection to data sheet (no password)","rory"]
[null,null,"created worst case (max len) intervention","Rory"]
[null,"v15","added draft \"how to use\"","Rory"]
[null,null,"imported printer VBA module","Rory"]
[null,null,"draft output template using worst case text lengths","Rory"]
["2017-04-20","v16","consolidated VB","Rory"]
[null,null,"first draft print output","Rory"]
[null,null,"updated How to use sheet","rory"]
[null,"v17","most text into textboxes","Rory"]
[null,"v17 ST","Added 'front end' format and content (purple tabs)","Sam"]
["2017-04-21","v18","debugged code","Rory"]
[null,"v19","import latest data","Rory"]
[null,"v20","transfer data to main data table","Rory"]
[null,null,"added admin sheets control","Rory"]
[null,"v21","added column with hyperlink addresses","Rory"]
[null,"v22","added hyperlinks to output pdf","Rory"]
[null,"v23 / 24","minor content / presentational amendments","sam"]
["2017-04-26","v25","QA 0-5 and 5-19 child programme interventions","Sam"]
["2017-04-27","v26","QA 0-5 and 5-19 child programme interventions","Sam"]
["2017-04-28","v27","Added obesity and PA evidence","Sam"]
[null,null,"Added formatting to data sheet","Sam"]
[null,null,"added AB comments on ADM (up to h18)","Sam"]
["2017-05-02","v29","Added formatting to data sheet","sam"]
[null,"v30","reset datasheet freeze panes","rory"]
[null,null,"added admin page (Ctrl-q to toggle)","rory"]
[null,null,"amended control button formats","Rory"]
[null,null,"revised max lengths","Rory"]
[null,null,"amended hyperlink intervention I4","Rory"]
[null,null,"amended output form to fit updated fields","rory"]
[null,null,"amended output form to single page A4","Rory"]
["2017-05-05","v31","consolidated notes pages","sam"]
[null,"v32","debugged code","Rory"]
[null,null,"amended user instructions","Rory"]
[null,null,"amended output form summary and assumptions","Rory"]
[null,"v33","further amendment to output form","Rory"]
[null,"v34","further amendment to output form","sam"]
[null,"v35","further amendment to output form","sam"]
["2017-05-09","v36","change output filename","rory"]
[null,"v37","further amendment to output form","rory"]
["2017-05-12","v38","removed colour from references","sam"]
["2017-05-15","v39","removed colour from HE evidence","sam"]
[null,null,"reviewing contentious data / issues /policy team comments","sam"]
[null,null,"sexual health","sam"]
[null,null,"added detail to matrix interventions","sam"]
["2017-05-16","v40","amendments to evidence","sam"]
["2017-05-16","v41","amended output format","sam"]
["2017-05-17","v42","tidying up evidence with issues","sam"]
[null,null,"completing front end content","sam"]
["2017-05-18","v44","remove ROI box on output","sam"]
[null,"v45","added NG64 evidence (ADM)","sam"]
[null,null,"amendments to evidence","sam"]
["2017-05-19","v46","ADM comments / S&T comments","sam"]
[null,null,"removed IBA evidence","sam"]
[null,null,"front end changes (BF comments)","sam"]
[null,null,"added extra detail S&T = lesley paper","sam"]
["2017-05-22","v47","added extra detail S&T = lesley paper","sam"]
["2017-05-23","v48","removed ROI field","rory"]
[null,null,"checked max lengths","Rory"]
[null,null,"updated hyperlink addresses","Rory"]
[null,null,"amended output box sizes","Rory"]
["2017-05-25",null,"alpha version sent for comments","Sam"]
[]
["BETA"]
["2017-06-09","v1","added 'alpha feedback' sheet","sam"]
[null,null,"vancouver reference - sources page","sam"]
[null,null,"working through comments (noted by action complete column)","sam"]
["2017-06-14",null,"added hover comments on data sheet","sam"]
[null,null,"added info on intervention description - ADM, 0-5, 5-9, HP, NHS HC","sam"]
[null,null,"grouped all oral health interventions","sam"]
["2017-06-19","v2","added info on intervention description - S&T, Obesity","sam"]
[null,null,"removed  Weight management interventions during pregnancy","sam"]
[null,null,"user guide changes","sam"]
["2017-06-20","v3","front end re-jig and amends to content","sam"]
[null,null,"amended user guide print area","rory"]
[null,null,"renamed \"for output\" to \"Select for report\"","rory"]
["2017-06-29","v4","amendments to D&O interventions (typos)","sam"]
[null,null,"rearranged D&O interventions","sam"]
["2017-06-29","v5","removed macro walking evidence £17 billion \"Active Travel\"","sam"]
[null,null,"added links to NICE guidance - further information","sam"]
["2017-06-30",null,"public health protection - 2011 papers added","sam"]
["2017-07-06","v6"]
["2017-07-13","v7","added alcohol evidence","sam"]
["2017-07-18","v8","formatting - so fits on 1 laptop screen (horizontally)","sam"]
[null,"v8a-v12","macros do not work (but formatting updated on them)","sam"]
["2017-07-20","v13","macros debugged","sam"]
[null,"v14","max length for report checks","sam"]
[null,"v15","cleaned up version","sam"]
[null,null,"removed internal references","sam"]
[null,null,"changed name: CBR to BCR","sam"]
[null,null,"taken out internal secondary sources","sam"]
[]
[null,"v17","added ph48","sam"]
[null,null,"manual update hyperlinks","sam"]
[null,"v18","FAQs active voice","sam"]
[null,"v19","removed LHS buttons","sam"]
[null,null,"updated glossary","sam"]
[null,"v22","RW changes","sam"]

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