For a study, researchers wanted to determine the cost-effectiveness of employing behavioral smoking cessation therapy during pregnancy. Researchers created a decision-analytic model using software to assess the cost-effectiveness and outcomes of behavioral smoking cessation therapy to standard treatment during pregnancy. They selected a theoretical cohort of 285,000 women, which was roughly the number of pregnant women who smoked in the United States each year. Maternal smoking cessation, fetal growth restriction, stillbirth, preterm delivery, neonatal mortality, and cerebral palsy were all outcomes, as were cost and quality-adjusted life-years (QALYs) for both the mother and the neonate. All model inputs were taken from the literature, and a willingness-to-pay threshold of $100,000 per QALY was established. To assess the robustness of the baseline assumptions, sensitivity analyses were carried out.
When compared to conventional treatment, behavioral smoking cessation counseling resulted in 9,019 more women quitting smoking while pregnant in our theoretical cohort (34,604 vs 25,585). There were 911 fewer occurrences of fetal growth restriction, 20 fewer stillbirths, 250 fewer preterm deliveries, 11 fewer neonatal deaths, and one less incidence of cerebral palsy as a result of smoking cessation counseling. Using behavioral smoking cessation counseling interventions during pregnancy resulted in better outcomes despite higher costs, with an incremental cost-effectiveness ratio of $71,658 per QALY, which was less than our willingness-to-pay threshold of $100,000 per QALY, indicating that the intervention was cost-effective. Sensitivity analysis revealed that the counseling intervention was cost-effective at a smoking cessation probability of more than 11.6% (baseline input: 12.1%) or behavioral intervention costs less than $475.21 (baseline input: $368.78).
Pregnancy smoking cessation counseling was related to less poor neonatal outcomes and was cost-effective. Increasing the use of such therapies and expanding insurance coverage for this care are critical objectives for improving outcomes in this vulnerable demographic.
