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Table 2 Cost-effectiveness of ECT and esketamine main model - base case and sensitivity analysis

From: Cost-utility analysis of esketamine and electroconvulsive therapy in adults with treatment-resistant depression

 

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

  1. a Dominates = more QALY at a lower cost
  2. Costs are displayed in British pounds (GBP) 2019