Table 3.
Base-case cost-effectiveness results
| Mean cost per patient | Mean QALY per patient | ICER | Incremental mean net health benefit per patient* (95% CI) | |||
| (95% CI) | (95% CI) | k=£15 000 | k=£20 000 | k=£30 000 | ||
| (P (most costly)) | (P (most effective)) | (probability of being cost-effective) | ||||
| Low PTL | ||||||
| NICE | £787.92 | 2.20095 | – | – | – | |
| (531.64 to 1046.85) | (2.05635 to 2.36087) | – | – | – | ||
| (0.047) | (0.130) | (0.160) | (0.153) | (0.147) | ||
| CMR | £846.00 | 2.28702 | £674.83 | 0.082 | 0.083 | 0.084 |
| (597.5 to 1098.28) | (2.19106 to 2.38562) | (−0.096 to 0.257) | (−0.093 to 0.258) | (−0.091 to 0.259) | ||
| (0.083) | (0.719) | (0.736) | (0.729) | (0.722) | ||
| MPS | £1061.94 | 2.22261 | Dominated | 0.003 | 0.008 | 0.013 |
| (835.89 to 1293.69) | (2.13167 to 2.3122) | (−0.173 to 0.171) | (−0.166 to 0.173) | (−0.161 to 0.177) | ||
| (0.870) | (0.151) | (0.104) | (0.118) | (0.131) | ||
| Medium PTL | ||||||
| CMR | £1301.97 | 2.19738 | 0.220 | 0.216 | 0.211 | |
| (1056.23 to 1560.61) | (2.09621 to 2.29582) | (0.047 to 0.398) | (0.041 to 0.393) | (0.036 to 0.388) | ||
| (0.074) | (0.642) | (0.688) | (0.682) | (0.671) | ||
| MPS | £1391.20 | 2.17327 | Dominated | 0.19 | 0.187 | 0.184 |
| (1105.68 to 1684.8) | (2.0717 to 2.26984) | (0.023 to 0.36) | (0.021 to 0.355) | (0.018 to 0.355) | ||
| (0.211) | (0.353) | (0.310) | (0.316) | (0.326) | ||
| NICE | £1565.28 | 1.99474 | Dominated | – | – | – |
| (1114.65 to 1991.53) | (1.85789 to 2.12644) | – | – | – | ||
| (0.715) | (0.005) | (0.002) | (0.002) | (0.003) | ||
| High PTL | ||||||
| CMR | £2514.86 | 2.15591 | 0.115 | 0.113 | 0.111 | |
| (2058.12 to 2936.73) | (2.06893 to 2.24084) | (−0.18 to 0.406) | (−0.185 to 0.401) | (−0.186 to 0.395) | ||
| (0.184) | (0.747) | (0.758) | (0.755) | (0.750) | ||
| NICE | £2638.37 | 2.04944 | Dominated | – | – | – |
| (2048.84 to 3213.82) | (1.78434 to 2.3057) | – | – | – | ||
| (0.400) | (0.213) | (0.204) | (0.207) | (0.211) | ||
| MPS | £2660.93 | 1.97525 | Dominated | −0.076 | −0.075 | −0.075 |
| (2154.92 to 3139.48) | (1.76637 to 2.18188) | (−0.368 to 0.213) | (−0.361 to 0.212) | (−0.358 to 0.213) | ||
| (0.416) | (0.040) | (0.038) | (0.038) | (0.039) | ||
| Overall | ||||||
| CMR | £1624.82 | 2.20568 | 0.146 | 0.144 | 0.141 | |
| (1431.4 to 1824.44) | (2.14564 to 2.26468) | (−0.013 to 0.306) | (−0.013 to 0.302) | (−0.013 to 0.302) | ||
| (0.073) | (0.917) | (0.931) | (0.926) | (0.925) | ||
| NICE | £1753.24 | 2.06854 | Dominated | – | – | – |
| (1473.15 to 2031.75) | (1.92352 to 2.20276) | – | – | – | ||
| (0.440) | (0.035) | (0.029) | (0.032) | (0.031) | ||
| MPS | £1767.87 | 2.11400 | Dominated | 0.044 | 0.045 | 0.045 |
| (1571.78 to 1989.15) | (2.01256 to 2.2169) | (−0.103 to 0.189) | (−0.101 to 0.187) | (−0.1 to 0.187) | ||
| (0.487) | (0.048) | (0.040) | (0.042) | (0.044) | ||
P (most costly): probability of a strategy being the most costly alternative.
P (most effective): probability of a strategy being the most effective alternative (ie, highest QALY gain).
*All incremental net health benefits are estimated compared with NICE-guided care.
CI, credible intervals; CMR, cardiovascular magnetic resonance; ICER, incremental cost-effectiveness ratio; k, cost-effectiveness threshold; MPS, myocardial perfusion scintigraphy; NICE, National Institute for Health and Care Excellence guidance; PTL, pretest likelihood; QALY, quality-adjusted life-years.