Table 20 Cost-effectiveness Outcomes: Stroke
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) |
|---|---|---|---|---|---|---|---|---|---|---|
Humphreys et al. 2015 [54*] | CEA | Incremental cost increase per patient over 24 months (extrapolated): | Intervention: £1388.90, not including cost of the intervention (£3349.90 including intervention cost); Control: £1541.70 | Change in SADQH-21 scale | Intervention: −6; Control: + 0.7 (p = 0.003) | ICER (cost per point reduction on the SADQH21 scale) | £263 | Bootstrapping Y/N (iterations): | Y (1000 replications) | Encouraging/promising (unclear - don’t know what society’s WTP is for a reduction in SADQH21) |
WTP Threshold(s) | £263 per point reduction in the SADQH21 score | |||||||||
Probability cost-effective at WTP | 100% | |||||||||
van Eeden et al. 2015 [99*] | CEA and CUA | Societal costs over 12 months | Intervention: €8064; Control: €9998; Different between the control group and the augmented CBT group not significant (95% CI:− 5284, 1796). | Change in HADS score | −0.8; | Cost per one point improvement in the HADS | ICER: €2395.3 (extendedly dominated) | Parameters varied | Price for a rehabilitation day treatment to a regular rehabilitation, varied consultation price, the friction cost method to calculate productivity costs instead of human capital approach, used a healthcare perspective and different sets of tariffs for utilities (Dutch and UK). (notably that for healthcare perspective the ICER is €107.454.70 and the intervention is no longer dominant) | Not cost-effective on the HADS; Unclear cost effectiveness per QALY gained - no significant effect on costs or QALYs |
Intervention costs | Intervention: €1130; Control: €592 (CogniPlus control cost) | QALYs gained | Intervention group gained slightly more QALYs - mean 0.01 | Cost per QALY gained | ICER - intervention dominant (although due to minimal difference in effects of 0.01 QALY gain) “these results should be interpreted with caution”. | Bootstrapping Y/N (iterations): | Y, (5000 replications). | |||
WTP Threshold(s) | €0 to €40,000 | |||||||||
Probability cost-effective at WTP | At WTP threshold of €2500, the probability of the augmented CBT intervention being cost-effective was 49%; At WTP of €40,000, the augmented CBT intervention had a 76% probability of being cost-effective. |