Total and incremental costs and consequences
| Scenario | Usual care | TEXT ME | ∆ Costs (millions) | MI avoided | Strokes avoided | QALYs gained | Incremental cost per QALY | ||||||
| Costs (millions) | MIs | Strokes | QALYs | Costs (millions) | MIs | Strokes | QALYs | ||||||
| Base case assumptions | 2758 | 21 819 | 7711 | 414 665 | 2747 | 21 257 | 7350 | 415 808 | −10.56 | 563 | 361 | 1143 | TEXT ME dominant |
| (2 012 to 2 552) | (21 235 to 22 418) | (7498 to 7969) | (399 185 to 432 167) | (2001 to 2540) | (20 632 to 21 986) | (7080 to 7642) | (400 365 to 433 218) | (−14.4 to −7.4) | (308 to 750) | (228 to 538) | (717 to 1667) | ||
| Scenario 1: Relative risk reductions mitigated entirely after 1 year | 2758 | 21 819 | 7711 | 414 665 | 2756 | 21 701 | 7633 | 414 943 | −1.08 | 118 | 78 | 278 | TEXT ME dominant |
| (2010 to 2545) | (21 233 to 22 406) | (7495 to 7948) | (399 075 to 430 764) | (2009 to 2544) | (21 108 to 22 312) | (7411 to 7870) | (399 371 to 431 068) | (−2.1 to −0.3) | (64 to 165) | (50 to 116) | (184 to 404) | ||
| Scenario 2: Risk of events reduced by 50% | 2649 | 14 007 | 4985 | 420 231 | 2642 | 13 548 | 4737 | 420 928 | −6.93 | 458 | 248 | 696 | TEXT ME dominant |
| (1900 to 2408) | (13 513 to 14 515) | (4798 to 5193) | (404 348 to 436 886) | (1894 to 2403) | (13 043 to 14 136) | (4536 to 4954) | (404 885 to 437 545) | (−9.8 to −4.8) | (290 to 596) | (173 to 343) | (467 to 1001) | ||
| Scenario 3: Treatment effects at lower CI | 2758 | 21 819 | 7711 | 414 665 | 2752 | 21 529 | 7484 | 415 325 | −5.34 | 290 | 227 | 660 | TEXT ME dominant |
| (2000 to 2533) | (21 226 to 22 422) | (7483 to 7975) | (398 362 to 432 156) | (1995 to 2528) | (20 950 to 22 224) | (7198 to 7764) | (399 120 to 432 812) | (−9.5 to −2.4) | (87 to 493) | (105 to 393) | (326 to 1162) | ||
| Scenario 4: cost of TEXT ME doubled | 2758 | 21 819 | 7711 | 414 665 | 2755 | 21 643 | 7596 | 415 069 | −2.38 | 176 | 116 | 404 | TEXT ME dominant |
| (1995 to 2564) | (21 216 to 22 411) | (7468 to 7957) | (398 417 to 431 503) | (1993 to 2562) | (21 037 to 22 263) | (7333 to 7847) | (398 818 to 431 836) | (−3.9 to −1.5) | (99 to 243) | (75 to 175) | (264 to 595) | ||
| All four scenario analyses simultaneously | 2649 | 14 007 | 4985 | 420 231 | 2649 | 13 956 | 4953 | 420 326 | 0.58 | 51 | 32 | 94 | $6123 |
| (1896 to 2445) | (13 519 to 14 512) | (4804 to 5189) | (404 966 to 437 458) | (1896 to 2445) | (13 462 to 14 468) | (4765 to 5158) | (405 039 to 437 534) | (−0.1 to 1.1) | (21 to 79) | (17 to 53) | (50 to 156) | ||
Expected (mean) values with 95% CI in parentheses. Tobacco, Exercise and Diet Messages (TEXT ME) is considered ‘dominant’ if it is expected to improve health outcomes and reduce healthcare costs. MI, myocardial infarction; QALYs, quality-adjusted life years.