title: The cost-effectiveness of a theory-based online health behaviour intervention for new university students: an economic evaluation.
abstract: BACKGROUND
  Too many young people engage in unhealthy behaviours such as eating unhealthily, being physically inactive, binge drinking and smoking. This study aimed to estimate the short-term and long-term cost-effectiveness of a theory-based online health behaviour intervention ("U@Uni") in comparison with control in young people starting university.
  
  
  METHODS
  A costing analysis was conducted to estimate the full cost of U@Uni and the cost of U@Uni roll-out. The short-term cost-effectiveness of U@Uni was estimated using statistical analysis of 6-month cost and health-related quality of life data from the U@Uni randomised controlled trial. An economic modelling analysis combined evidence from the trial with published evidence of the effect of health behaviours on mortality risk and general population data on health behaviours, to estimate the lifetime cost-effectiveness of U@Uni in terms of incremental cost per QALY. Costs and effects were discounted at 1.5% per annum. A full probabilistic sensitivity analysis was conducted to account for uncertainty in model inputs and provide an estimate of the value of information for groups of important parameters.
  
  
  RESULTS
  To implement U@Uni for the randomised controlled trial was estimated to cost £292 per participant, whereas roll-out to another university was estimated to cost £19.71, both giving a QALY gain of 0.0128 per participant. The short-term (6-month) analysis suggested that U@Uni would not be cost-effective at a willingness-to-pay threshold of £20,000 per QALY (incremental cost per QALY gained = £243,926). When a lifetime horizon was adopted the results suggest that the full implementation of U@Uni is unlikely to be cost-effective, whereas the roll-out of U@Uni to another university is extremely likely to be cost-effective. The value of information analysis suggests that the most important drivers of decision uncertainty are uncertainties in the effect of U@Uni on health behaviours.
  
  
  CONCLUSIONS
  The study provides the first estimate of the costs and cost-effectiveness of an online health behaviour intervention targeted at new university students. The results suggest that the roll-out, but not the full implementation, of U@Uni would be a cost-effective decision for the UK Department of Health, given a lifetime perspective and a willingness-to pay threshold of £20,000 per QALY.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN67684181.
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, United Kingdom. jen.kruger512@gmail.com.
authors.forename: Jen
authors.initials: J
authors.lastname: Kruger
authors.forename: Alan
authors.initials: A
authors.lastname: Brennan
authors.forename: Mark
authors.initials: M
authors.lastname: Strong
authors.forename: Chloe
authors.initials: C
authors.lastname: Thomas
authors.forename: Paul
authors.initials: P
authors.lastname: Norman
authors.forename: Tracy
authors.initials: T
authors.lastname: Epton
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008297:Male; D017059:Models, Econometric; D011788:Quality of Life; D000074606:Smoking Prevention; D013334:Students / Q000706:statistics & numerical data*; D014495:Universities; D055815:Young Adult