Authors, 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) |
---|---|---|---|---|---|---|---|---|---|---|
Chernyak et al. 2014 [43*] | CUA | Costs (direct treatment): | Intervention: €893; Control: €141 | SF-36 PCS (mean improvement): | Intervention: 5.3; Control: 2.2 | ICER (cost per QALY gained): | €41,840 per QALY gained | Parameters varied | Handling of missing data (exclude, LOCF and imputation) | Highly uncertain |
SF-6D (improvement) | Intervention: 0.09; Control: 0.04 | Bootstrapping Y/N (iterations): | Y (5000 replications); | |||||||
WTP Threshold(s) | €35,000 per QALY gained | |||||||||
Probability cost-effective at WTP | “exceeded 50%” | |||||||||
Schroder et al. 2017 [91*] | CUA | Annual healthcare costs | STreSS at 1 year pre treatment €3544, 4 months €2369, 1 year €2250, 2 years €2560, 3 years €523; EUC at 1 year pre-treatment,€4106 at 4 months €976, at 1 year €4200, at 2 years €3937 and 3 years €1132 | % achieving clinically significant improvement during 16 months, defined as 0.5 SD change (4 point increase) on SF-36 aggregate score and 0.35 points reduction on the SCL-90 R somatisation subscale. | STreSS: 45% (30–60); EUC: 17% (7–27) | ICER (cost per additional patient with clinically significant improvement, cost per QALY gained using healthcare costs only, cost per QALY gained using total costs): | €3035 to €4398 per patient improved; Intervention was dominant per QALY gained when healthcare costs used; €24,640 euros per QALY gained at 16 months when total costs used. | Bootstrapping Y/N (iterations): | Y (1000 replications) | Cost effective per QALY gained (for societal perspective the cost-effectiveness may be underestimated) |
Annual costs (direct plus indirect including tax income) | STreSS at 1 year pre-treatment €12,489, 4 months €5487, 1 year €11,118, 2 years €9353, 3 years €6334; EUC at 1 year pre-treatment €15,904, at 4 months €3888, at 1 year €14,799, at 2 years €16,109 at 3 years €15,701 | QALYs accrued at 16 months (SF-36 converted to SF-6D) | STreSS: 0.80; EUC: 0.75 | WTP Threshold(s) | €5000 per additional patient achieving clinically significant improvement, €25,000 to 35,000 per QALY | |||||
Probability cost-effective at WTP | 93–95% (health-care perspective); 50-55% (societal perspective but healthcare threshold used) | |||||||||
van Ravesteijn et al. 2013 [101*] | CUA | Mean societal costs over 1 year (bootstrapped): | Intervention: €6269; Control: €5617; Total costs were not significantly different, but mental health care costs were higher and hospital care costs lower in the intervention group. | Change in utility score over 1 year | Intervention: 0.06; Control: 0.04 | ICER (cost per QALY gained): | Societal perspective: €56,637 per QALY gained Healthcare perspective: €66,450 | Parameters varied | Scenario analysis that varied perspective, and using per protocol trial data (ICERs ranged from €41,167 to €53,198) | Uncertain whether MBCT is cost-effective. |
Mean costs of intervention | Intervention: €450; Control: N/A | QALYs gained | Intervention: 0.674; Control: 0.663; Bootstrapped difference in QALYs 0.012 (95% CI −0.019 to 0.041) was not statistically significant. | Bootstrapping Y/N (iterations): | Y, (1000 replications). | |||||
WTP Threshold(s) | €0 to €80,000 | |||||||||
Probability cost-effective at WTP | Societal perspective: At WTP threshold of €0, the probability of MBCT being cost effective is 28%. At WTP of €40,000 this is 48%. At €80,000 it is 57%. Healthcare perspective results “did not significantly differ [from societal perspective]”, At a WTP threshold of €80,000 the probability that MBCT is cost-effective is 55%. | |||||||||
Visser et al. 2015 [103*] | CUA (Markov model) | Societal costs over 4 years | Intervention: €32,929; Control: €33,757 | QALYs gained | Intervention: 2.35 QALYs; Control: 2.29 QALYs | ICER (cost per QALY gained): | Intervention dominant from societal perspective; €8165 for healthcare perspective | Parameters varied | Probabilistic sensitivity analysis (10,000 iterations). Scenario analysis including only healthcare perspective, time horizon. | Cost effective |
Healthcare costs over 4 years | Intervention: €21,757; Control: €21,278 | WTP Threshold(s) | €30,000 per gained QALY | |||||||
Probability cost-effective at WTP | 80% at WTP threshold. |