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Table 3 Simulation Results

From: Estimating the effectiveness and cost-effectiveness of establishing additional endovascular Thrombectomy stroke Centres in England: a discrete event simulation

OutcomeEstimate
Mean time to treatment reduction (SD)42 min (SD 63)
Changes in population mRS (n) *
 015
 118
 2-4
 3-10
 4−8
 5−8
 6−4
Marginal Lifetime QALY gains across English pop.213 (95% CI 28, 447)
Marginal Lifetime costs to NHS England-£2,870,000 (95% CI -£7,946,000 to £2,051,000)
Net Benefit at £20,000 per QALYb£7,123,000 (95% CI £1,039,000 to £13,666,000)
Net Benefit at £25,000 per QALYb£8,187,000 (95% CI £1,609,000 to £ 15,684,000)
Net Benefit at £30,000 per QALYb£ 9,250,000 (95% CI £1,983,000 to £ 17,532,000)
Budget Impact Analysis
 Year 1-£981,000(95% CI -£2,067,000 to £218,000)
 Years 2 to 5 (discounted)- £1,186,000 (95% CI -£3,587,000 to £1,187,000)
Sensitivity Analyses expressed as change in Net Benefit at £25,000 willingness to pay for QALY
 Use of Ambulance Tariff£20,000
 1% increase in LAO incidence£93,000
 1% decrease in LAO incidence-£72,000
 Mean age at stroke −5 years (65)£1,023,000 22 additional QALYs, additional savings of £473,000
 Mean age at stroke + 5 years (75)-£934,000 27 fewer QALYs, reduction in savings of £259,000
  1. aRounded to nearest number of patients
  2. bNet benefit is calculated by deducting the ‘value’ of QALYs generated from increased costs