Towards sustainable mental health promotion: trial-based health-economic evaluation of a positive psychology intervention versus usual care

Table 3 Cost-effectiveness analysis and sensitivity analysis with flourishing as health outcome

Flourishing	Total sample	Alternative scenarios
		A	B	C
Costs, €^a	239	196	617	223
Effect	0.19	0.19	0.19	0.20
ICER, €^b	1245	1058	3240	1099
Distribution on the cost-effectiveness plane
1st quadrant (northeast)	92	86	100	89
2nd quadrant (inferior: northwest)	0	0	0	0
3rd quadrant (southwest)	0	0	0	0
4th quadrant (superior: southeast)	8	14	0	11
WTP ceiling, %
€ 0	12	18	4	14
€ 10,000	93	92	91	93
€ 20,000	97	97	96	97
€ 30,000	100	100	100	100

Scenario A = adjustment of the per participant intervention costs, based on actual costs for counseling (the number of extensive emails sent by each participant multiplied by €17); scenario B = intervention costs raised from €222 to €600; scenario C = completers only analysis (n = 112 intervention group and n = 125 control group)
^aCosts per ‘disease-free’ year (i.e. one year in flourishing mental health) at 2014 prices
^bBootstrapped median, which is the 50th percentile of 2500 replications of the ICER

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