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Next to considerations of cost effectiveness, decision makers should factor in many other aspects, ranging from ethical considerations to practical implementations.
40 41 Finally, we note that in addition to considerations about cost effectiveness, decision makers need to estimate carefully the possible uptake of vaccination, considering the potentially large impact on budgets of a risk based vaccination programme using the 13 valent pneumococcal conjugate vaccine.
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However, the Evidence Review Group on behalf of NICE conducted an exploratory analysis that did vary the mortality multiplier for blindness (BCVA ≤35 letters), with no effect on the cost-effectiveness decision [ 39].
Under alternative model assumptions, the cost-effectiveness decision remains in favour of cryotherapy.
There is little uncertainty in the cost-effectiveness decision over a wider range of willingness to pay thresholds, as demonstrated in the CEAC (figure 3).
However, the number of treatments in years 1 and 2 were varied in deterministic and probabilistic sensitivity analyses and did not affect the cost-effectiveness decision.
The question whether the reward should be offered could in this case be seen as a simple cost-effectiveness decision, informed by the impact of the incentive on the target behavior.
Cost-effectiveness will be assessed using the net-benefit statistic, a reformulation of the cost-effectiveness decision rule that does not rely on cost-effectiveness ratios with their associated statistical problems [ 38].
Sensitivity analyses (table 3B) illustrate that the outcomes remain mostly unchanged to modifications in key model assumptions; and where outcomes do change, the cost-effectiveness decision remains in favour of cryotherapy.
A cost-effectiveness decision-analytic model was built using TreeAge Pro®.
Moreover, as global healthcare budgets tighten, assessing health-related quality of life and health status to facilitate cost-effectiveness decisions is becoming increasingly important.
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