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Table 3 Cost-effectiveness of ECT and esketamine maintenance model with M-ECT - 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 525,707 16.83 456,219 14.26 69,488 2.57 27,070
 Healthcare perspective 220,303 16.83 120,392 14.26 99,911 2.57 38,922
Sensitivity analysis
 (1a) Doubling the productivity loss 736,918 16.83 688,314 14.26 48,604 2.57 18,935
 (1b) Halving the productivity loss 420,102 16.83 340,172 14.26 79,930 2.57 31,138
 (2a) ECT six times per cycle during depression – societal 522,167 16.83 456,219 14.26 65,948 2.57 25,691
 (2b) ECT six times per cycle during depression – healthcare 216,879 16.83 120,392 14.26 96,487 2.57 37,588
 (2c) ECT 12 times per cycle during depression – societal 532,787 16.83 456,219 14.26 76,568 2.57 29,828
 (2d) ECT 12 times per cycle during depression – healthcare 227,152 16.83 120,392 14.26 106,760 2.57 41,590
 (3a) Increasing the remission rate from esketamine to 0.5 – societal 525,707 16.83 458,462 14.36 67,245 2.46 27,290
 (3b) Increasing the remission rate from esketamine to 0.5 – healthcare 220,303 16.83 123,587 14.36 96,717 2.46 39,250
 (4a) Decreasing the remission rate from ECT to 0.5 – societal 490,004 15.54 456,219 14.26 33,784 1.28 26,326
 (4b) Decreasing the remission rate from ECT to 0.5 – healthcare 164,091 15.54 120,392 14.26 43,699 1.28 34,052
 (5a) Increasing the remission rate the 2nd time the individuals received ECT/esketamine 0.9 – societal 595,181 18.89 472,830 15.08 122,351 3.82 32,059
 (5b) Increasing the remission rate the 2nd time the individuals received ECT/esketamine 0.9 – healthcare 332,551 18.89 148,080 15.08 184,471 3.82 48,336
 (6a) Five-year time horizon – societal 127,153 3.21 116,088 2.81 11,066 0.4 27,570
 (6b) Five-year time horizon – healthcare 65,956 3.21 31,285 2.81 34,671 0.4 86,383
 (7a) Lowering QALYs (0.3) for ECT treatment during depression and increasing QALYs (0.85) for remission after esketamine and AD – societal 525,707 16.99 456,219 14.55 69,488 2.45 28,378
 (7b) Lowering QALYs (0.3) for ECT treatment during depression and increasing QALYs
    (0.85) for remission after esketamine and AD – healthcare
220,303 16.99 120,392 14.55 99,911 2.45 40,802
 (8a) Esketamine was given as long as the individual was in remission – societal 525,707 16.83 424,948 14.41 100,759 2.42 41,660
 (8b) Esketamine was given as long as the individual was in remission – healthcare 220,303 16.83 124,358 14.41 95,945 2.42 39,670
 (9a) No discounting applied – societal 540,562 17.22 469,612 14.60 70,950 2.42 27,063
 (9b) No discounting applied – healthcare 227,209 17.22 123,193 14.60 104,016 2.42 39,676
  1. Costs are displayed in British pounds (GBP) 2019