We have limited data on whether SMS interventions are
cost-effective. Cost-effectiveness analyses are complex; the costper quality adjusted life years saved (QALYS) is the
recommended outcome measure when comparing the costeffectiveness
of different interventions.100 However, the impact
on health outcomes with behavioral or self-management interventions
may not be evident for many years, making QALYS
and return on investment difficult to estimate. Although welldesigned
longitudinal studies should be conducted to measure
the cost-effectiveness of self-management interventions, accurate
cost analyses of interventions provides an intermediate step
of benefit to both policy makers and funders. Readers are
encouraged to collect their own cost data using feasible cost collection
procedures.101