Cost-effectiveness of alternate contact protocols and costs of mammography promotion interventions for women veterans

To identify and evaluate the costs of implementing a print-based mammography promotion intervention and the cost-effectiveness of four alternative protocols for contacting the target population and obtaining a response to the baseline survey. Data are from a random sample of 8446 individuals from the National Registry of Women Veterans (NRWV). Models are developed to estimate the societal costs and the local site costs for a targeted intervention and a more intensive tailored intervention. Costs (in 2001 US dollars), are estimated for each stage of the contact protocol, and incremental cost-effectiveness ratios assess the efficiency of each additional step in making contact with the target population and in completion of the baseline survey. Participants' assignments to the site cost models are dependant on responses to earlier attempts to contact them. The societal cost of implementing the intervention is $54 per participant for the tailored program and $47 per participant for the targeted program. The local site cost ranges from $25 to 38 per participant for the tailored intervention and $18–31 per participant for the targeted intervention. The incremental cost-effectiveness ratios range from $18 to 29 when effect is defined as contact and range from $59 to 183 when effect is defined as survey completion. A print-based mammography intervention program is feasible in the Veterans Affairs Medical Centers, and going beyond a two-step contact protocol is not recommended.