PHiD-CV was assumed to be slightly more effective (25% effectiveness instead of 20.5% as shown in NCKP trial [ 34]) than PCV-7 against radiologically confirmed pneumonia (used as a proxy for hospitalized pneumonia) based on expert opinion given that the additional serotypes covered by this vaccine are frequent agents of severe pneumonia.
The acid solutions (with solid solutes) all displayed similar effectiveness, and were all slightly more effective, on a per mole basis, than the DMMP solution (a liquid solute).
If clean non-coated catheters are not considered a relevant option, gel reservoir catheters are slightly more effective than hydrophilic with a small additional cost and an incremental cost effectiveness ratio of about £3000 per QALY.
The inclusion of pertussis related deaths would probably lead to a slightly more favourable cost-effectiveness as adolescent vaccination is estimated to slightly decrease the incidence in the most vulnerable group (i.e. young infants).
These results show that the use of Spanish observational data not only increases the external validity of the results, but also yields a slightly more favourable cost-effectiveness outcome than the use of international clinical trial data.
DPP group lifestyle was estimated to be slightly more costly but much more effective than placebo with a cost-effectiveness ratio of $1,000 per QALY gained.
Intervention cost-effectiveness ratios are slightly more favourable when not discounted, due to greater intervention health gains and cost offsets (Text S5).
The cost-effectiveness would be slightly more favorable if the duration of immunity after natural infection is 8 years (ICER: €4418 per QALY) compared to 15 years (ICER: €6371 per QALY).
If we remove the predicted trends in disease incidence and case fatality, intervention cost-effectiveness ratios become slightly more favourable, but the difference is small and the overall result (five out of 23 interventions cost-effective) remains the same.
Discounting health outcomes at a lower rate than costs led to cost-effectiveness ratios that were slightly more in favour of tiotropium.
