Introduction
Methods
Model construction
Literature review
Model parameter | Description | China mean (range) | USA mean (range) |
---|---|---|---|
Transitions | |||
Surgery | |||
Sur Comp | Probability of complication after treatment | 0.024 (0.023 to 0.035) | |
Sur Asym | Probability of no symptom after treatment | 0.728 (0.469 to 0.967) | |
Sur Re | Probability of recurrence after treatment | 0.429 (0.429 to 7.400a) | |
Drug therapy | |||
Drug Sym | Probability of symptoms after treatment | 0.372 (0.233 to 0.500) | |
Drug Re | Probability of recurrence after treatment | 0.244 (0.200 to 0.268) | |
Costs | |||
Surgery | |||
Cost Surg | Cost of surgery | $1000 ($527 to $1196) | $1658 ($1093 to $2866) |
Cost Comp | Cost of surgery and cost of complication | $319 ($287 to $351) | $1605 ($883 to $3226) |
Drug | |||
Drug cost | Cost of the drug therapy | $130.5 ($130.5 to $145) | $688.5 ($567 to $3888) |
Utilities | |||
Eff Sym | Health state utility of the symptomatic patients | 0.778 | 0.611–0.81 |
Eff Sur | Health state utility of the asymptomatic patients in the surgery group | 0.854 | 0.828–0.882 |
Eff Drug | Health state utility of the asymptomatic patients in the drug group | 0.965 | 0.89–0.965 |
Transition probabilities
Costs and utilities
Cost-effectiveness analysis
Results
Base-case analysis
China | US | |||
---|---|---|---|---|
Cost | QALYs | Cost | QALYs | |
Surgery | 1069.0 | 4.10 | 1994.4 | 4.10 |
Drug | 753.7 | 3.58 | 3977.7 | 3.58 |
Incremental cost/QALY | 315.3 | 0.52 | − 1983.3 | 0.52 |
ICER | 604.0 | Dominant |