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Table 3 Scenario analyses and their impact on health gain, health system costs, and incremental cost-effectiveness ratios per person screened, New Zealand dollars 2011

From: A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity

 

Incremental costs (NZ$)

Incremental QALYs gained

Incremental cost-effectiveness ratio

 

Total

Māori

Non-Māori

Total

Māori

Non-Māori

Total

Māori

Non-Māori

Main modela

$119

$138

$117

0.006

0.014

0.005

$20,600

$10,100

$24,700

Equity analysis—equal life expectancy and background morbidity for Māori and non-Māori

$121

$155

$117

0.006

0.019

0.005

$18,800

$8,200

$24,700

Equal coverage—coverage in Māori was set to the same as non-Māori (84%)

$120

$143

$117

0.006

0.014

0.005

$20,400

$10,000

$24,700

Low coverage—coverage in Māori of 45% and non-Māori of 58% akin to a NZ colorectal screening pilot

$93

$95

$93

0.004

0.008

0.003

$24,500

$12,400

$28,400

Equal eradication—triple therapy was increased to be 95% effective (e.g. levofloxacin)

$118

$132

$116

0.006

0.015

0.005

$19,600

$8,900

$24,200

No retest to ensure effective eradication

$101

$107

$100

0.005

0.010

0.004

$20,600

$10,900

$23,600

Follow-up for 15 years (rather than over a lifetime)

$118

$132

$116

0.003

0.008

0.003

$35,600

$16,000

$44,000

The effect size in the youngest age groups is greater (<40yo, RR of 0.50)

$119

$139

$117

0.006

0.016

0.005

$18,400

$8,700

$22,500

The complication rate for CDI was increased from 80 to 800 per 100,000

$124

$146

$121

0.006

0.014

0.005

$21,400

$10,700

$25,600

6% discounting QALYs and costs

$112

$118

$111

0.003

0.007

0.002

$39,200

$17,300

$48,200

0% discounting QALYs and costs

$151

$225

$141

0.015

0.034

0.012

$10,300

$6,600

$11,700

No unrelated health system costs

$82

$52

$86

0.006

0.014

0.005

$14,200

$3,800

$18,300

No pYLDs (background morbidity)

$119

$138

$117

0.008

0.021

0.007

$14,300

$6,700

$17,500

  1. Deterministic results were used in the sensitivity analysis for efficiency and differ slightly from probabilistic results
  2. aMain model includes 3% discounting of both QALYs and costs