Table 2.
Probabilistic outcomes of 40-year societal cost-utility analysis
| N = 385,192 | Usual care | Recommended care | Incremental |
|---|---|---|---|
| Public sector costsa | Mean (SE) | Mean (SE) | Mean (SE) |
| (1) All-cause public sector costsb | £10,060,099,947 (£99,415,713) |
£9,936,609,337 (£98,628,205) |
-£123,490,610 (£5,909,603) |
| (2) Fall-related healthcare costs |
£663,114,733 (£28,095,762) |
£560,737,568 (£23,700,572) |
-£102,377,165 (£5,504,016) |
| Public sector intervention costs |
£33,992,444 (£2,186,958) |
£430,663,194 (£8,281,037) |
£396,670,750 (£7,888,734) |
| QALY |
2,091,707 (10,224) |
2,110,653 (10,238) |
18,946 (499) |
| Societal outcomes | |||
| Productivity | |||
| Productivity valuec |
£12,828,548,949 (£738,143,648) |
£12,867,696,042 (£740,545,423) |
£39,147,094 (£4,280,003) |
| Intervention TOC |
£1,198,057 (£143,984) |
£42,417,182 (£2,592,854) |
£41,219,125 (£2,594,679) |
| Net productivity gain |
-£2,072,031 (£1,327,648) |
||
| Personal finance | |||
| OOP care expenditured |
£2,523,459,511 (£111,570,114) |
£2,478,690,212 (£109,989,355) |
-£44,769,299 (£2,914,804) |
| Intervention private co-payment |
£8,855,861 (£606,367) |
£75,446,429 (£4,512,590) |
£66,590,569 (£4,554,691) |
| Net personal finance cost |
£21,821,270 (£1,543,638) |
||
| Informal caregiver burden | |||
| Informal caregiving coste |
£14,884,116,295 (£902,879,471) |
£14,744,953,134 (£894,187,914) |
-£139,163,161 (£10,486,904) |
| Intervention caregiver TOC |
£356,678 (£22,893) |
£51,535,375 (£3,439,769) |
£51,178,696 (£3,439,868) |
| Net informal caregiver cost |
-£87,984,465 (£8,660,865) |
||
| Societal gain, QALY equivalent | 1,068 QALYs | ||
| Jack-knife mean (95% UI)e | |||
| Societal ICER using (1)f |
£14,067 per QALY gained (£12,011—£15,923) |
||
| Societal ICER using (2) |
£15,149 per QALY gained (£13,193—£17,006) |
||
| Mean (95% UI)g | |||
| Societal INMB using (1) |
£327,260,886 (£286,031,713—£368,490,059) |
||
| Societal INMB using (2) |
£295,215,304 (£261,690,664—£328,739,943) |
||
Abbreviation: ICER Incremental cost-effectiveness ratio, INMB Incremental net monetary benefit, OOP Out-of-pocket, QALY Quality-adjusted life year, SE Standard error, TOC Time opportunity cost, UI Uncertainty interval
aAll outcomes were averaged across 20 model trial runs with different random number seeds
bIncludes costs of fall-related primary and secondary healthcare, comorbidity primary and secondary healthcare, cost of dying, community healthcare, short-term social care, all-cause long-term care
cIncludes values of paid and unpaid employment
dIncludes OOP care expenditure and privately incurred long-term care cost
eICERs are computed using the jack-knife method to avoid bias associated with ratios [60]
fThe jack-knife means for public sector ICERs are £15,367 per QALY gained using [1] and £15,829 using [2]
gThe incremental net monetary benefits were estimated from the incremental outcomes rather than from jack-knife method using the cost-effectiveness threshold of £30,000 per QALY gained