Table 6.
Summary of cost-utility analysis for base case, and by scenario and sub-group.
| Analysis | Cost difference | QALY difference | INMB @ £20 k/QALY | INMB @ £30 k/QALY | ICER |
|---|---|---|---|---|---|
| Base casea | 1033 (−1189 to 3225) | 0.02 (0.00–0.05) | −598 (−2832 to 1681) | −381 (−2663 to 1976) | 47,540 |
| Scenario | |||||
| EQ-VASa | 1114 (−1090 to 3286) | 0.03 (0.01–0.05) | −561 (−2716 to 1654) | −285 (−2462 to 1949) | 40,310 |
| Assume only MET useda | 859 (−1761 to 3033) | 0.02 (0.00–0.05) | −420 (−2627 to 2223) | −201 (−2428 to 2481) | 39,167 |
| Lower BUP-XR cost (£239.70)a | 896 (−1305 to 2981) | 0.02 (0.00–0.05) | −462 (−2608 to 1738) | −246 (−2475 to 1965) | 41,324 |
| BUP-SL/MET daily superviseda | 839 (−1375 to 2959) | 0.02 (0.00–0.05) | −406 (−2572 to 1805) | −190 (−2417 to 2098) | 38,781 |
| BUP-SL/MET fortnightly unsuperviseda | 1155 (−1018 to 3332) | 0.02 (0.00–0.05) | −720 (−2960 to 1539) | −503 (−2794 to 1795) | 53,111 |
| Best casea, b | 573 (−1703 to 2595) | 0.02 (0.00–0.05) | −141 (−2234 to 2094) | 75 (−2097 to 2344) | 26,546 |
| Worst casea, c | 1436 (−792 to 3660) | 0.02 (0.00–0.05) | −1003 (−3212 to 1253) | −787 (−3088 to 1511) | 66,383 |
| NHS + PSS + CJ + A/Base case | 1001 (−1209 to 3186) | 0.02 (0.00–0.04) | −576 (−2793 to 1698) | −363 (−2596 to 1977) | 47,047 |
| NHS + PSS + CJ/Base case | 1300 (−659 to 3377) | 0.02 (0.00–0.04) | −885 (−3043 to 1089) | −678 (−2892 to 1330) | 62,717 |
| NHS + PSS/Base case | 944 (−136 to 2264) | 0.02 (0.00–0.04) | −522 (−1895 to 607) | −312 (−1701 to 906) | 44,785 |
| NHS + PSS/Lower BUP-XR cost (£239.70) | 786 (−275 to 2018) | 0.02 (0.00–0.04) | −365 (−1636 to 761) | −154 (−1503 to 1053) | 37,323 |
| NHS/Base case | 962 (−93 to 2286) | 0.02 (0.00–0.04) | −534 (−1879 to 589) | −320 (−1764 to 868) | 44,955 |
| Sub-group | |||||
| Use of cocainea | 3062 (−3553 to 10,435) | 0.02 (−0.03 to 0.08) | −2623 (−10,023 to 4044) | −2404 (−9821 to 4407) | 139,469 |
| Use of benzodiazepinesa | 3500 (−5588 to 13,181) | 0.03 (−0.03 to 0.11) | −2854 (−12,431 to 6483) | −2531 (−12,216 to 7005) | 108,356 |
| CGI-S rating severea | −3147 (−11,435 to 4149) | 0.05 (−0.01 to 0.11) | 4136 (−3262 to 12,391) | 4630 (−2876 to 12,982) | Dominant |
| Treatment episode > 28 daysa | −102 (−4368 to 3370) | 0.02 (−0.01 to 0.05) | 576 (−2926 to 4850) | 812 (−2779 to 5089) | Dominant |
Data are mean (95% central range); Estimates from bootstrapped and imputed data, adjusted for baseline costs and utilities, site, and injecting status.
BUP-SL, sublingual tablet buprenorphine; INMB, Incremental Net Monetary Benefits; MET, oral liquid methadone.
a
Societal perspective; NHS + PSS + CJ + A is NHS is Personal Social Services, Criminal Justice, and Accommodation perspective.
b
BUP-SL/MET at February 2019 prices (inflated to 2021 prices using HCHS index) with assumption of six supervised medication pick-ups per week.
c
BUP-SL/MET at July 2018 prices (inflated to 2021 prices using HCHS index) and assuming one unsupervised medication pick-up per fortnight.