ECT | Esketamine | Incremental | ICER | ||||
---|---|---|---|---|---|---|---|
Cost | QALY | Cost | QALY | Cost | QALY | ||
Base case | |||||||
Societal perspective | 453,693 | 14.85 | 456,211 | 14.26 | −2517 | 0.59 | ECT dominatesa |
Healthcare perspective | 124,530 | 14.85 | 120,390 | 14.26 | 4140 | 0.59 | 6969 |
Sensitivity analysis | |||||||
(1a) Doubling the productivity loss | 681,736 | 14.85 | 688,301 | 14.26 | −6565 | 0.59 | ECT dominates |
(1b) Halving the productivity loss | 339,673 | 14.85 | 340,165 | 14.26 | −493 | 0.59 | ECT dominates |
(2a) ECT six times per cycle – societal | 450,071 | 14.85 | 456,211 | 14.26 | −6140 | 0.59 | ECT dominates |
(2b) ECT six times per cycle – healthcare | 121,026 | 14.85 | 120,390 | 14.26 | 636 | 0.59 | 1070 |
(2c) ECT 12 times per cycle – societal | 460,939 | 14.85 | 456,211 | 14.26 | 4728 | 0.59 | 7959 |
(2d) ECT 12 times per cycle – healthcare | 131,539 | 14.85 | 120,390 | 14.26 | 11,149 | 0.59 | 18,768 |
(3a) Increasing the remission rate from esketamine to 0.5 – societal | 453,694 | 14.85 | 458,449 | 14.36 | −4755 | 0.49 | ECT dominates |
(3b) Increasing the remission rate from esketamine to 0.5 – healthcare | 124,530 | 14.85 | 123,583 | 14.36 | 947 | 0.49 | 1927 |
(4a) Decreasing the remission rate from ECT to 0.5 – societal | 453,364 | 14.42 | 456,211 | 14.26 | −2847 | 0.16 | ECT dominates |
(4b) Decreasing the remission rate from ECT to 0.5 – healthcare | 119,350 | 14.42 | 120,390 | 14.26 | −1040 | 0.16 | ECT dominates |
(5a) Increasing the remission rate the 2nd time the individuals received ECT/esketamine 0.9 – societal | 448,644 | 16.15 | 472,803 | 15.08 | −24,159 | 1.08 | ECT dominates |
(5b) Increasing the remission rate the 2nd time the individuals received ECT/esketamine 0.9 – healthcare | 141,026 | 16.15 | 148,069 | 15.08 | −7044 | 1.08 | ECT dominates |
(6a) Five-year time horizon – societal | 105,078 | 3.00 | 116,086 | 2.81 | −11,008 | 0.19 | ECT dominates |
(6b) Five-year time horizon – healthcare | 31,691 | 3.00 | 31,284 | 2.81 | 406 | 0.19 | 2086 |
(7a) Lowering QALYs (0.3) for ECT treatment during depression and increasing QALYs (0.85) for remission after esketamine and AD – societal | 453,694 | 15.04 | 456,211 | 14.54 | −2517 | 0.5 | ECT dominates |
(7b) Lowering QALYs (0.3) for ECT treatment during depression and increasing QALYs (0.85) for remission after esketamine and AD – healthcare | 124,530 | 15.04 | 120,390 | 14.54 | 4140 | 0.5 | 8296 |
(8a) Esketamine was given as long as the individual was in remission – societal | 453,694 | 14.85 | 458,749 | 14.41 | −5055 | 0.45 | ECT dominates |
(8b) Esketamine was given as long as the individual was in remission – healthcare | 124,530 | 14.85 | 124,358 | 14.41 | 172 | 0.45 | 387 |
(9a) No discounting applied – societal | 466,497 | 15.22 | 469,603 | 14.60 | −3106 | 0.61 | ECT dominates |
(9b) No discounting applied – healthcare | 127,589 | 15.22 | 123,191 | 14.60 | 4399 | 0.61 | 7156 |