Table 2.

Base case results.

Intervention	Mean costs ($)	Mean QALYs	Mean difference in costs ($)	Mean difference in QALYs
ACE inhibitors	$15,000	3.2	N/A (Comparator)	N/A (Comparator)
ARBs	$16,500	3.3	+$1500	+0.1

Incremental results:

Incremental Cost: The mean difference in costs between ARBs and ACE inhibitors is 1500, indicating that ARBs are associated with higher mean costs than ACE inhibitors.

Incremental Effectiveness: The mean difference in Quality-Adjusted Life Years (QALYs) between ARBs and ACE inhibitors is + 0.1, indicating that ARBs result in a slight increase in QALYs compared to ACE inhibitors.

Incremental cost-effectiveness ratio (ICER):

The ICER is calculated as the incremental cost divided by the total effectiveness (ΔCost/ ΔQALY). In this hypothetical example:

ICER = $1500/0.1 = $15,000 per additional QALY gained when using ARBs compared to ACE inhibitors.

Interpretation:

The ICER of $15,000 per additional QALY gained suggests that using ARBs instead of ACE inhibitors in heart failure management may be cost-effective within the context of the analysis. This value represents the additional cost required to achieve one additional QALY with ARBs compared to ACE inhibitors.

Decision-makers should consider the cost-effectiveness threshold, which represents the maximum amount they are willing to pay for an additional QALY. If the ICER falls below this threshold, it may support the adoption of ARBs as a cost-effective intervention.

Sensitivity analyses should be conducted to assess the robustness of these results under different assumptions and parameter variations. This helps decision-makers understand the uncertainty surrounding the cost-effectiveness estimate.

ACE = angiotensin-converting enzyme, ARBs = angiotensin receptor blockers.