We then recorded or calculated the incremental cost-efficacy ratio for each venous thromboembolism prophylaxis strategy.
If we were unable to calculate the incremental cost-efficacy ratio because of missing data, we attempted to contact the authors to obtain this ratio or original data.
Heterogeneity of the interventions, perspectives, and time-horizons precluded meta-analytic techniques to combine incremental cost-efficacy ratios into a single summary statistic.
HFS, hip-fracture surgery; ICER, incremental cost-efficacy ratio; LMWH, low-molecular-weight heparin; THR, total hip replacement; UFH, unfractionated heparin; USD, United States dollars; VTE, venous thromboembolism.
Low-molecular-weight heparins were reported to be economically more attractive than warfarin in all eight studies among surgical patients, with incremental cost-efficacy ratios of $874 to $26,711 per venous thromboembolism event avoided in five of the comparisons [ 34, 35, 37, 38, 40], the dominant strategy in three comparisons [ 36, 39, 41].
Two studies reported an incremental cost-efficacy ratio of $1,180 and $1,445 per venous thromboembolism event avoided when using enoxaparin [ 26, 29], and two studies found incremental cost-effectiveness ratios of $10,360 per death avoided and $20,337 per quality-adjusted life-year gained with low-molecular-weight heparins.
Pharmacoeconomic analyses examine the incremental cost per unit of efficacy, with OS as the typical unit for efficacy, to obtain an overall incremental cost per life year gained between two treatments.
26 Scatter plot distribution of ICER was plotted on a cost-effectiveness plane where the incremental cost is represented along the y-axis and the incremental efficacy is represented along the x-axis.
The results of the scenario analyses (table 5) and the univariate sensitivity analysis (fig 3) show that the predicted herd effects of the infant programme and vaccine efficacy have a large impact on the incremental cost effectiveness ratios.
Accordingly, rotavirus vaccination appeared less cost-effective; for instance, assuming this alternate efficacy and I$25 per vaccinated child, only seven countries had an incremental cost per DALY averted under I$100 (Table 4).
If efficacy was increased to 93%, the CE ranking remained consistent but the incremental cost per active TB case prevented for each strategy decreased by approximately £15,000 per 1000 contacts screened compared to base-case estimates.
