Table 6.
Total hip replacement economic results
| Difference (intervention – control) a | ||||
|---|---|---|---|---|
| N | Mean | (95 % CI) | P value | |
| MAIN ANALYSIS: NHS and personal social services (PSS) perspective | ||||
| Mean QALY gain | 322 | 0.052 | (0.017 to 0.087) | 0.004 |
| Mean NHS+PSS cost difference | 322 | –£86 | (£–571 to £399) | 0.730 |
| Incremental net monetary benefit – lambda £10,000 | 322 | £606 | (£–55 to £1,266) | 0.072 |
| Incremental net monetary benefit – lambda £20,000 | 322 | £1,125 | (£183 to £2,067) | 0.019 |
| Incremental net monetary benefit – lambda £30,000 | 322 | £1,645 | (£385 to £2,905) | 0.011 |
| SECONDARY ANALYSIS: NHS perspective only | ||||
| Mean NHS cost difference | 322 | £78 | (£–347 to £502) | 0.720 |
| Incremental net monetary benefit – lambda £20,000 | 322 | £961 | (£50 to £1,873) | 0.039 |
| Incremental Cost per point in WOMAC pain decrease b | 322 | £16 | (£–16,591 to £16,622)c | 0.999 |
| SENSITIVITY ANALYSIS: Using macro-costed prescribed medications | ||||
| Prescribed medications b | 322 | –£24 | (£–28 to £–20) | |
| Mean QALY gain | 322 | 0.052 | (0.017 to 0.087) | 0.004 |
| Mean NHS+PSS cost difference | 322 | –£107 | (£–590 to £376) | 0.660 |
| Incremental Net Monetary Benefit – lambda £20,000 | 322 | £1,666 | (£406 to £2,925) | 0.010 |
| SENSITIVITY ANALYSIS: 50 % higher local inpatient costs | ||||
| Initial inpatient stay b | 322 | –£50 | (£–156 to £56) | |
| Mean QALY gain | 322 | 0.052 | (0.017 to 0.088) | 0.004 |
| Mean NHS+PSS cost difference | 322 | –£106 | (£–697 to £485) | 0.730 |
| Incremental net monetary benefit – lambda £20,000 | 322 | £1,151 | (£121 to £2,181) | 0.028 |
| SENSITIVITY ANALYSIS: 50 % lower local inpatient costs | ||||
| Initial inpatient stay b | 322 | –£8 | (£–44 to £27) | |
| Mean QALY gain | 322 | 0.050 | (0.015 to 0.086) | 0.006 |
| Mean NHS+PSS cost difference | 322 | –£44 | (£–445 to £358) | 0.830 |
| Incremental net monetary benefit – lambda £20,000 | 322 | £1,051 | (£164 to £1,938) | 0.020 |
| SENSITIVITY ANALYSIS: dropping high cost patients | ||||
| Mean QALY gain | 320 | 0.052 | (0.016 to 0.088) | 0.004 |
| Mean NHS+PSS cost difference | 320 | –£73 | (£–449 to £302) | 0.70 |
| Incremental net monetary benefit – lambda £20,000 | 320 | £1,121 | (£ 215 to £2,026) | 0.015 |
a All results are adjusted for minimisation variables, and baseline utility for QALYs, M=20 multiple imputation sets, bootstrapped confidence intervals with 1000 replications, except results noted with b
b Unadjusted estimates with imputed data using M=20 multiple imputation sets
c This confidence interval includes negative ICER values. These negative values indicate that the intervention is dominant