title: Cost-effectiveness of a text message programme for the prevention of recurrent cardiovascular events.
abstract: To estimate the cost-effectiveness of Tobacco, Exercise and Diet Messages (TEXT ME), a text message-based intervention that provides advice, motivation, information and support to improve health-related behaviours.
  
  
  
  A lifetime Markov model was used to estimate major vascular events (myocardial infarctions and strokes) avoided, quality-adjusted life years (QALYs) gained, costs to the health system and the incremental cost per QALY gained. The model was informed by data from a randomised controlled trial of TEXT ME, with evidence from systematic reviews and meta-analyses used to estimate the effects of changes in risk factors on the risk of major vascular events. Expected costs and health outcomes were estimated with uncertainty surrounding these characterised using probabilistic sensitivity analysis and a number of scenario analyses.
  
  
  
  For a target population of 50 000 patients with documented coronary heart disease, the intervention is expected to lead to 563 fewer myocardial infarctions, 361 fewer strokes and 1143 additional QALYs. TEXT ME is expected to lead to an overall saving of $10.56 million for the health system over the patients' lifetimes. The intervention can therefore be considered cost-saving and health-improving. Neither parameter nor structural uncertainty had a significant impact on the conclusion that TEXT ME is cost-effective.
  
  
  
  The provision of TEXT ME is predicted to lead to better health outcomes and an overall saving in costs for the health system.
  
  
  
  anzctr.org.au identifier: ACTRN12611000161921.
authors.affiliation: Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Burn
authors.affiliation: Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Son
authors.initials: S
authors.lastname: Nghiem
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Redfern
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Rodgers
authors.affiliation: Department of Cardiology, Westmead Hospital, Sydney, Australia.|Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Aravinda
authors.initials: A
authors.lastname: Thiagalingam
authors.affiliation: Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Graves
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.|Department of Cardiology, Westmead Hospital, Sydney, Australia.|Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Clara K
authors.initials: CK
authors.lastname: Chow
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D019057:Quality-Adjusted Life Years; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000191:economics* / Q000379:methods; D060145:Text Messaging / Q000191:economics*
keywords: cost effectiveness; mHealth; secondary prevention of cardiovascular disease; text-messaging interventions