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The acceptability curve presents the probability that a treatment is the most cost effective of the three treatments at different threshold values for cost effectiveness (ceiling ratio), whereas the cost-effectiveness acceptability frontier demonstrates which of the three treatments should be adopted because it results in the highest expected net benefit, given the ceiling ratio.
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Nice, often criticised for being slow to approve drugs for the NHS, has moved at record speed, and the manufacturer Bristol-Myers Squibb has made the process easier by agreeing to a discount on the price the NHS is charged which brings it below Nice's cost-effectiveness ceiling of £30,000 per year of quality life gained.
The results for the subgroups are also depicted as cost effectiveness planes and value of ceiling ratios in Figure 2.
For QALYs gained, the cost effectiveness acceptability curves indicated that integrated care was cost effective for all possible ceiling ratios.
We will use EQ-5D as our measure of utility to generate a cost per QALY and Cost Effectiveness Acceptability Curve (CEAC) for comparison with the NICE ceiling of £30,000 [ 61].
A secondary cost-utility analysis, using the EQ-5D as the measure of utility to generate a cost per QALY (ICER) and Cost Effectiveness Acceptability Curve (CEAC) for comparison with the National Institute for Health and Care Excellence (NICE) ceiling threshold of £20 000 to £30 000.
Therefore, the bootstrapped ICERs will also be depicted in a cost effectiveness acceptability curve showing the probability that the intervention care is cost effective using a range of ceiling ratios.
Cost effectiveness acceptability curves indicated that the probability of integrated care being cost effective compared with usual care was larger than 95% for ceiling ratios larger than £10 for sustainable return to work.
However, the cost effectiveness acceptability curves showed a 95% probability that the addition of the water-based programme is a cost effective strategy if the ceiling of inversion is €14,200/QALYY and a 97.5% probability if the ceiling is set at €21,233/QALYY.
"Cost effectiveness is only a factor".
We recommend two types of cost-effectiveness calculations - average cost effectiveness, and incremental cost effectiveness.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com