Table 12 Cost-effectiveness Outcomes: CHD
Author, Year | Type of Analysis/ | Type of Costs | Costs | Type of effectiveness outcome | Effectiveness | ICER (definition); | ICER (results) | Sensitivity Analysis (definitions) | Sensitivity analysis (results) | Authors conclude (Reviewer comments where these differ from authors) |
|---|---|---|---|---|---|---|---|---|---|---|
Ladapo et al. 2012 [63*] | CUA (SF-12/ SF-6D) | Costs | Intervention: $1857; Control: $2797; Adjusted mean difference− 1229 (95%CI:− 2652 to 195), p = 0.09 | Utility | Intervention: 0.60; Control: 0.56; Not statistically significant; p = 0.07 | ICER (cost per QALY gained): | Intervention dominates | WTP Threshold | $30,000 | Reduces costs but further research needed (unclear what proportion of iterations were less costly but less effective) |
Bootstrapping (Y/N; replications): | Y; 1000 | |||||||||
Probability treatment is cost effective at WTP threshold(s) | 98%. | |||||||||
Mejia et al. 2014 [75*] | CUA | Difference in costs (complete case analysis) | £320.99 (95% CI: -£1524 to £2166) | Difference in effectiveness (adjusting for baseline utility): | −0.02 (95% CI 0.09 to 0.05). There were no substantial differences in the utility scores between treatment groups in all follow-up assessments | ICER (cost per QALY gained) | Control dominates as results indicate reduction on utility/quality of life. | Parameters varied in sensitivity analysis | Varying price year to 2011/12, complete case analysis, multiple imputation. | The uncertainty around both estimates of cost and effectiveness mean that it is not reasonable to make recommendations based on cost-effectiveness alone. |
Difference in QALYs | −0.004 | WTP Threshold | £20,000 and 30,000 per QALY | |||||||
Probability treatment is cost effective at WTP threshold(s) | The probability that the intervention is cost-effective for thresholds between 20,000 and 30,000 is around 45%. | |||||||||
Tyrer et al. 2017 [95*] | CUA (EQ-5D) | Total costs per patient | Intervention (CBT-CP): £2235.53 Standard care: £3732.02 in standard care group Difference: -£1496.49 (not significant). | Health anxiety Inventory, HADS, LMHAQ-CP scores, A and E attendances after 6 months/1 year, SEPS scores | Difference: “greater improvement in the CBT-CP group than for standard care in at 12 months compared with 6 months” (not significant). Difference in scores at 6 and 12 months between the TAU (control) and treatment (intervention) groups was not significant. | ICER (cost per QALY gained): | Not reported. CBT-CP dominated standard care (better outcomes and lower costs). | Bootstrapping (Y/N; replications): | Bootstrapping for 95% CIs for costs but no further sensitivity analysis details reported | Potentially cost-effective (needs further research). |
Hospital service costs | Difference -£177.52, “more than covered the costs of the CBT-CP” | QALY gains (from EQ-5D) reported over the follow up | Intervention: 0.76 QALYs; Control: 0.74; Difference was not significant QALY over follow up for the CBT-CP group. | |||||||
Community costs per participant | Intervention: £480; Control: £480 |