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Table 6 Total hip replacement economic results

From: Local anaesthetic wound infiltration in addition to standard anaesthetic regimen in total hip and knee replacement: long-term cost-effectiveness analyses alongside the APEX randomised controlled trials

 

Difference (intervention – control) a

 

N

Mean

(95 % CI)

P value

MAIN ANALYSIS: NHS and personal social services (PSS) perspective

    

Mean QALY gain

322

0.052

(0.017 to 0.087)

0.004

Mean NHS+PSS cost difference

322

–£86

(£–571 to £399)

0.730

Incremental net monetary benefit – lambda £10,000

322

£606

(£–55 to £1,266)

0.072

Incremental net monetary benefit – lambda £20,000

322

£1,125

(£183 to £2,067)

0.019

Incremental net monetary benefit – lambda £30,000

322

£1,645

(£385 to £2,905)

0.011

SECONDARY ANALYSIS: NHS perspective only

    

Mean NHS cost difference

322

£78

(£–347 to £502)

0.720

Incremental net monetary benefit – lambda £20,000

322

£961

(£50 to £1,873)

0.039

Incremental Cost per point in WOMAC pain decrease b

322

£16

(£–16,591 to £16,622)c

0.999

SENSITIVITY ANALYSIS: Using macro-costed prescribed medications

    

Prescribed medications b

322

–£24

(£–28 to £–20)

 

Mean QALY gain

322

0.052

(0.017 to 0.087)

0.004

Mean NHS+PSS cost difference

322

–£107

(£–590 to £376)

0.660

Incremental Net Monetary Benefit – lambda £20,000

322

£1,666

(£406 to £2,925)

0.010

SENSITIVITY ANALYSIS: 50 % higher local inpatient costs

    

Initial inpatient stay b

322

–£50

(£–156 to £56)

 

Mean QALY gain

322

0.052

(0.017 to 0.088)

0.004

Mean NHS+PSS cost difference

322

–£106

(£–697 to £485)

0.730

Incremental net monetary benefit – lambda £20,000

322

£1,151

(£121 to £2,181)

0.028

SENSITIVITY ANALYSIS: 50 % lower local inpatient costs

    

Initial inpatient stay b

322

–£8

(£–44 to £27)

 

Mean QALY gain

322

0.050

(0.015 to 0.086)

0.006

Mean NHS+PSS cost difference

322

–£44

(£–445 to £358)

0.830

Incremental net monetary benefit – lambda £20,000

322

£1,051

(£164 to £1,938)

0.020

SENSITIVITY ANALYSIS: dropping high cost patients

    

Mean QALY gain

320

0.052

(0.016 to 0.088)

0.004

Mean NHS+PSS cost difference

320

–£73

(£–449 to £302)

0.70

Incremental net monetary benefit – lambda £20,000

320

£1,121

(£ 215 to £2,026)

0.015

  1. a All results are adjusted for minimisation variables, and baseline utility for QALYs, M=20 multiple imputation sets, bootstrapped confidence intervals with 1000 replications, except results noted with b
  2. b Unadjusted estimates with imputed data using M=20 multiple imputation sets
  3. c This confidence interval includes negative ICER values. These negative values indicate that the intervention is dominant