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Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial

Shaun Harris Orcid Logo, Berni Sewell, Monica Busse‐Morris, Adrian Edwards, Fiona Jones, Fiona Leggat Orcid Logo, Philip Pallman, Deborah Fitzsimmons Orcid Logo

Health Expectations, Volume: 28, Issue: 4

Swansea University Authors: Shaun Harris Orcid Logo, Berni Sewell, Deborah Fitzsimmons Orcid Logo

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DOI (Published version): 10.1111/hex.70357

Abstract

BackgroundIn the United Kingdom, at least 1.9 million people are estimated to have experienced long Covid, of which 1.3 million have symptoms lasting for more than a year. The Long CovId Personalised Self-managemenT support EvaluatioN (LISTEN) trial evaluated the effectiveness and cost-effectiveness...

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Published in: Health Expectations
ISSN: 1369-6513 1369-7625
Published: Wiley 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69969
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The Long CovId Personalised Self-managemenT support EvaluatioN (LISTEN) trial evaluated the effectiveness and cost-effectiveness of a co-designed personalised self-management support intervention for non-hospitalised people living with long Covid.MethodsWe conducted a pragmatic, multicentre, two-arm, parallel group and superiority randomised controlled trial for people who had experienced at least one long Covid symptom for 12 weeks or longer. A cost&#x2013;utility analysis was undertaken alongside the LISTEN trial from both a UK National Health Service (NHS) and personal social services (PSS) and a societal perspective. Implementation costs were determined from study records, and quality of life and health and care resource use were collected by questionnaire at 6-week and 3-month follow-ups. Incremental net monetary benefit (INMB) analyses evaluated the cost-effectiveness of the intervention at a range of willingness-to-pay thresholds.ResultsA total of 544 participants were included in the health economic analysis, of which 62.5% had complete data. The average cost of delivering the LISTEN intervention was &#xA3;846 per participant. At 3-month follow-up, mean quality-adjusted life years (QALYs) were 0.005 (95% CI &#x2212;0.004 to 0.014) greater for participants receiving the LISTEN intervention compared to usual care. From the NHS and PSS perspective, total adjusted mean costs were &#xA3;491 (95% CI, &#xA3;128 to &#xA3;854) lower in the usual care arm. From the societal perspective, participants in the usual care arm lost more hours of work and usual activities and received more informal care, with the LISTEN intervention dominating usual care.ConclusionsAt accepted UK thresholds, the LISTEN intervention was not cost-effective from an NHS and PSS perspective, but it was found to be cost-effective from a societal perspective due to the impact of long Covid on work, informal care and usual activities. 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spelling 2025-09-03T17:23:11.3282524 v2 69969 2025-07-15 Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial 10b1bd08dbad1f2681ff1e527af9f9a3 0000-0001-7724-6621 Shaun Harris Shaun Harris true false f6a4af2cfa4275d2a8ebba292fa14421 Berni Sewell Berni Sewell true false e900d99a0977beccf607233b10c66b43 0000-0002-7286-8410 Deborah Fitzsimmons Deborah Fitzsimmons true false 2025-07-15 MEDS BackgroundIn the United Kingdom, at least 1.9 million people are estimated to have experienced long Covid, of which 1.3 million have symptoms lasting for more than a year. The Long CovId Personalised Self-managemenT support EvaluatioN (LISTEN) trial evaluated the effectiveness and cost-effectiveness of a co-designed personalised self-management support intervention for non-hospitalised people living with long Covid.MethodsWe conducted a pragmatic, multicentre, two-arm, parallel group and superiority randomised controlled trial for people who had experienced at least one long Covid symptom for 12 weeks or longer. A cost–utility analysis was undertaken alongside the LISTEN trial from both a UK National Health Service (NHS) and personal social services (PSS) and a societal perspective. Implementation costs were determined from study records, and quality of life and health and care resource use were collected by questionnaire at 6-week and 3-month follow-ups. Incremental net monetary benefit (INMB) analyses evaluated the cost-effectiveness of the intervention at a range of willingness-to-pay thresholds.ResultsA total of 544 participants were included in the health economic analysis, of which 62.5% had complete data. The average cost of delivering the LISTEN intervention was £846 per participant. At 3-month follow-up, mean quality-adjusted life years (QALYs) were 0.005 (95% CI −0.004 to 0.014) greater for participants receiving the LISTEN intervention compared to usual care. From the NHS and PSS perspective, total adjusted mean costs were £491 (95% CI, £128 to £854) lower in the usual care arm. From the societal perspective, participants in the usual care arm lost more hours of work and usual activities and received more informal care, with the LISTEN intervention dominating usual care.ConclusionsAt accepted UK thresholds, the LISTEN intervention was not cost-effective from an NHS and PSS perspective, but it was found to be cost-effective from a societal perspective due to the impact of long Covid on work, informal care and usual activities. Further research is required to understand the costs and benefits of self-management support for longer-term horizons. Journal Article Health Expectations 28 4 Wiley 1369-6513 1369-7625 cost‐effectiveness; Covid‐19; long Covid; rehabilitation; self‐management 4 8 2025 2025-08-04 10.1111/hex.70357 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University SU Library paid the OA fee (TA Institutional Deal) This trial was funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme (COV‐LT2‐0009). 2025-09-03T17:23:11.3282524 2025-07-15T12:30:02.7409608 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Shaun Harris 0000-0001-7724-6621 1 Berni Sewell 2 Monica Busse‐Morris 3 Adrian Edwards 4 Fiona Jones 5 Fiona Leggat 0000-0002-6754-7225 6 Philip Pallman 7 Deborah Fitzsimmons 0000-0002-7286-8410 8 69969__35021__1242570633154437924dbc90b9ecfb04.pdf 69969.VoR.pdf 2025-09-03T17:20:19.3276494 Output 336851 application/pdf Version of Record true © 2025 The Author(s). This is an open access article under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
spellingShingle Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
Shaun Harris
Berni Sewell
Deborah Fitzsimmons
title_short Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
title_full Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
title_fullStr Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
title_full_unstemmed Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
title_sort Cost‐Effectiveness of a Personalised Self‐Management Intervention for People Living With Long Covid: The LISTEN Randomised Controlled Trial
author_id_str_mv 10b1bd08dbad1f2681ff1e527af9f9a3
f6a4af2cfa4275d2a8ebba292fa14421
e900d99a0977beccf607233b10c66b43
author_id_fullname_str_mv 10b1bd08dbad1f2681ff1e527af9f9a3_***_Shaun Harris
f6a4af2cfa4275d2a8ebba292fa14421_***_Berni Sewell
e900d99a0977beccf607233b10c66b43_***_Deborah Fitzsimmons
author Shaun Harris
Berni Sewell
Deborah Fitzsimmons
author2 Shaun Harris
Berni Sewell
Monica Busse‐Morris
Adrian Edwards
Fiona Jones
Fiona Leggat
Philip Pallman
Deborah Fitzsimmons
format Journal article
container_title Health Expectations
container_volume 28
container_issue 4
publishDate 2025
institution Swansea University
issn 1369-6513
1369-7625
doi_str_mv 10.1111/hex.70357
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description BackgroundIn the United Kingdom, at least 1.9 million people are estimated to have experienced long Covid, of which 1.3 million have symptoms lasting for more than a year. The Long CovId Personalised Self-managemenT support EvaluatioN (LISTEN) trial evaluated the effectiveness and cost-effectiveness of a co-designed personalised self-management support intervention for non-hospitalised people living with long Covid.MethodsWe conducted a pragmatic, multicentre, two-arm, parallel group and superiority randomised controlled trial for people who had experienced at least one long Covid symptom for 12 weeks or longer. A cost–utility analysis was undertaken alongside the LISTEN trial from both a UK National Health Service (NHS) and personal social services (PSS) and a societal perspective. Implementation costs were determined from study records, and quality of life and health and care resource use were collected by questionnaire at 6-week and 3-month follow-ups. Incremental net monetary benefit (INMB) analyses evaluated the cost-effectiveness of the intervention at a range of willingness-to-pay thresholds.ResultsA total of 544 participants were included in the health economic analysis, of which 62.5% had complete data. The average cost of delivering the LISTEN intervention was £846 per participant. At 3-month follow-up, mean quality-adjusted life years (QALYs) were 0.005 (95% CI −0.004 to 0.014) greater for participants receiving the LISTEN intervention compared to usual care. From the NHS and PSS perspective, total adjusted mean costs were £491 (95% CI, £128 to £854) lower in the usual care arm. From the societal perspective, participants in the usual care arm lost more hours of work and usual activities and received more informal care, with the LISTEN intervention dominating usual care.ConclusionsAt accepted UK thresholds, the LISTEN intervention was not cost-effective from an NHS and PSS perspective, but it was found to be cost-effective from a societal perspective due to the impact of long Covid on work, informal care and usual activities. Further research is required to understand the costs and benefits of self-management support for longer-term horizons.
published_date 2025-08-04T05:29:36Z
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