Fig. 1.

Cost-effectiveness plane. The results of cost-effectiveness analyses comparing a novel therapy with the prior standard of care can be depicted on a cost-effectiveness plane. The x-axis represents incremental outcomes (e.g., incremental quality-adjusted life years [QALYs]) and the y-axis represents incremental costs when the new therapy is used compared with the standard of care. In sensitivity analyses, the exercise of estimating incremental costs and incremental QALYs is repeated by sampling each of the key input parameters from statistical distributions that represent uncertainty in these parameters. The panels below depict three hypothetical novel drugs compared with the prior standard of care. In each panel, the diagonal line represents the cost-effectiveness threshold of $100,000 per QALY gained and the ellipse depicts the 95% credible interval of the incremental cost-effectiveness ratio. In panel A, the new therapy improves health outcomes and lower costs, i.e., is cost saving. In this setting, the new therapy is considered the dominant or superior option and should be adopted. In panel B, the new therapy improves health outcomes but also increases costs, such that the incremental cost per QALY gained exceeds the cost-effectiveness threshold of $100,000 per QALY gained. Thus, the new therapy would not be considered cost-effective relative to the comparator. In panel C, the new therapy improves health outcomes and increases costs, but the incremental cost per QALY gained is less than the cost-effectiveness threshold of $100,000 per QALY gained, suggesting that the new therapy is likely to be cost-effective compared with the prior standard of care. In this case, the new therapy would not be considered cost-effective relative to the comparator