A Critique of Cost-Effectiveness Analysis of the Real Cost Campaign’s Effect on Smoking Prevention, Article Critique Example

Introduction

The aim of the study was in translating approximately 350,000 youths prevented from initiating smoking between 2014 and 2016 into monetary terms. Assessing returns on investments and the cost-utility of public health expenditures is vital to shareholders and policymakers. The paper emphasizes that the stakeholders can adequately determine whether the economic investments made in the campaigns can be justified by the public health outcomes (Graham & Tetroe, 2007, p. 21). It also provided evidence for any potential cost savings for the outcomes.

Methods

The use of the QALY method inhibits the process of giving a clear comparison of the relationship that exists between individual and social preferences. A clear method such as regression analysis makes it possible to assess the sensitivity of factor towards a change to other elements within the model. The behaviour of individuals could be analyzed over the years with the per the cost changes for advertising. There is also an ethical implication in the use of the QALY. As a method of assessing and giving data regarding a population under study, all limitations have to be eliminated. Valuing of an individual’s life over that of the other cannot be hinged on individuals having a perfect health condition.

QALY, as assessed in the paper, aims at reducing the budgetary allocation instead of advising policymakers on how to increase the efficiency in resources allocated. It a prescriptive measure and therefore limits the choices, and ultimately leads to autonomy in decisions to be made. The quantitative nature of the QALY makes it a utilitarian approach; hence its results cannot be considered as being optimal (Cromwell, 1997, p. 16).

There is no justification provided for the methodology used in the study. The estimated number of smokers averted between 2014 and 2016 were used in the study. There was no evidence of how the sample was selected. The outcomes are to be compared with what would have been without the study being initiated. The model therefore has been used to analyze data which is small in size, and the sample can also be regarded as being non-representative (Altman et al., 1987, p. 163). The above has an effect on the reliability as well as the validity of measurements that are focused on the utility.

Results

The cost of campaign between 2013 and March 2016 was at $246,915,233 depicting the effort that the federal government have put in place in combating the fast-rising vice. The number of youths that have been prevented from initiating smoking due to the adverts was at 348,398. The Real Cost has been attributed with averting an estimated 175,941 youths between 2014 and 2016 from smoking. The cost per quality-adjusted life year saved over the same period was at $1,337. The overall return on investments over the same period was at $128 n cost savings.

The usage of tobacco among high school students has been on the rise with the majority opting to use electronic cigarettes according to research findings by (Wang et al., 2018, p. 12). Data points to the fact that if the current use of tobacco continues, 5.6 million of today’s population will die early due to use of tobacco. Heavy investment in advertisements will deter non-users from engaging in the behavior but until the reasons for early use are understood, many will be affected (“Knowledge translation in health care: Moving from evidence to practice,” 2009, p. 36). The different tobacco products, how they are sourced and means of minimizing access among the young depict areas of research that can push the whole conversation further.

Discussion

The cost per QALY saved was $1,337, which is a similar figure found in other studies. There are other studies that targeted the cessation among adults and found the figures at $268 and $37,355. There is a need for comparison as different researchers made use of different methods in their studies. The lack of in-depth data analysis limits the conclusions that are to be made from the study. The responsiveness of different components had to be measured.

The study gives sufficient evidence on the savings that are to be made. Adolescents below the age of 15.5 years have the highest level of savings at $180,000 per smoker. There is a consideration for the external costs, where there is a saving of $4 for every $1 spent. The paper also assesses the evidence as put across from the previous studies. Considering different information sources has the importance of increasing the dependability of the findings.

The model in use limits the process of assessing the number of youths limited from initiating smoking. The QALY saved from the research and LYs are consistent with previous research. They are based on date life tables. The limitation is such that if the relationship between smoking and longevity over the same period, then it will limit the nature of conclusions to be made from the results. The above factor, considered in unison with the fact that no clear way of how data presented was selected from the sample limits the findings.

Ethical issues have not been assessed, and they affected the process of gathering and analyzing data. The time changes also mean that certain variables within the model were to be affected. Where the variables and the attributed changes were not factored means that certain costs had been understated. The cost savings, therefore, cannot give a true picture. The data that was used to estimate the progression from initiation phase to established smoking behaviour was between 1992 and 1995.

Table 1: Estimation of the progression from initiation phase to established smoking behaviour

Figure 1: Regression of Some of the cost elements

Conclusion

The cost-effectiveness, as assessed through the study, has different implications and informs policy in a myriad of ways. The savings that are to be made from youth smoking are at $31 billion. The savings are to be attributed to a decline in the financial burden on the youth’s dependants. There is no evidence; however, on how the findings from the study can be transferred to other sectors of the economy. Tobacco abuse is a phenomenon that has been affecting individuals as well as countries around the globe. Therefore, the emergence of social media, as well as the fast-paced growing internet can significantly push adverts on various platforms that can inform cardinal decisions pertaining the youths.

Reference List

Altman, D. G., Flora, J. A., Fortmann, S. P., & Farquhar, J. W. (1987). The cost-effectiveness of three smoking cessation programs. American Journal of Public Health, 77(2), 162-165.

Cromwell, J. 1997. Cost-effectiveness of the clinical practice recommendations in the AHCPR guideline for smoking cessation. JAMA: The Journal of the American Medical Association, 278(21), 1759.

Graham, I., & Tetroe, J. 2007. CIHR research: How to translate health research knowledge into effective healthcare action. Healthcare Quarterly, 10(3), 20-22.

Knowledge translation in health care: Moving from evidence to practice. 2009. International Journal of Health Care Quality Assurance, 22(6).

Wang, T. W., Coats, E. M., Gammon, D. G., Loomis, B. R., Kuiper, N. M., Rogers, T., & King, B. A. 2018. National and state-specific unit sales and prices for electronic cigarettes, United States, 2012–2016. Preventing Chronic Disease, 15.