Table 7.
Results of sensitivity analysis* showing effects on cost effectiveness of variation in utility value of remission, risk of adverse events, length of stay, and calculation of risk of need for repeat surgery
| Treatment strategy | Cost (£) | Incremental cost (£) | Effectiveness (QALYs) | Incremental effectiveness (QALYs) | Incremental cost effectiveness ratio (£/QALYs) |
|---|---|---|---|---|---|
| Utility of IPSS <8 is 0.97 | |||||
| Diathermy vaporisation | 380 774 844 | 893 516 | |||
| Holmium laser enucleation | 400 549 783 | 19 774 939 | 894 844 | 1328 | 14 889 |
| Diathermy vaporisation + holmium vaporisation | 413 712 972 | 13 163 189 | 895 584 | 740 | 17 791 |
| Diathermy vaporisation + TURP repeated once if necessary | 418 264 231 | 4 551 258 | 895 611 | 28 | 163 682 |
| Relative risk of adverse events from all studies | |||||
| Diathermy vaporisation | 380 774 844 | 917 082 | |||
| Holmium laser enucleation | 400 549 783 | 19 774 939 | 919 656 | 2574 | 7682 |
| Diathermy vaporisation + holmium vaporisation | 413 712 972 | 13 163 189 | 921 041 | 1385 | 9505 |
| Length of stay for TURP = length of stay for diathermy vaporisation = 2 days | |||||
| Diathermy vaporisation | 376 715 152 | 917 082 | |||
| TURP | 380 679 392 | 3 964 240 | 918 222 | 1140 | 3476 |
| TURP repeated once if necessary | 400 362 758 | 19 683 366 | 920 340 | 2117 | 9296 |
| Diathermy vaporisation + TURP repeated once if necessary | 409 495 593 | 9 132 834 | 921 091 | 751 | 12 156 |
| Alternative calculation of probability of failure | |||||
| Diathermy vaporisation | 380 793 296 | 918 558 | |||
| Diathermy vaporisation + holmium vaporisation | 404 008 222 | 23 214 926 | 921 217 | 2659 | 8731 |
| Diathermy vaporisation + TURP repeated once if necessary | 406 972 673 | 2 964 451 | 921 269 | 52 | 56 845 |
QALY=quality adjusted life year; IPSS=international prostate symptom score; TURP=transurethral resection of prostate.
*Based on 10 000 Monte Carlo simulation samples and showing non-dominated and non-extendedly dominated strategies only.