Sensitivity analysis | Change | Optimum invite, %b | Risk threshold | Cost, £ | Incremental QALYs | Net benefit, £c |
---|---|---|---|---|---|---|
Base case | Not applicable | 8 | 0.1276 | 162 280 | 17.53 | 188 397 |
Uptake assessment | Reduce from 63% to 46% uptake | 8 | 0.1276 | 120 310 | 12.99 | 139 516 |
Start medication | Reduce by 50%d | 6 | 0.1445 | 69 060 | 7.36 | 78 155 |
Stop medication | Increase by 50%e | 20 | 0.0721 | 191 759 | 18.47 | 177 579 |
Assessment cost | Reduce by 50% (£37.20) | 40 | 0.0339 | 326 023 | 28.50 | 243 943 |
Annual monitoring cost | Reduce by 50% (£60.06) | 30 | 0.0488 | 116 314 | 27.20 | 427 743 |
RR of diabetes SA1 | Change from 1.31 to 0.99 | 30 | 0.0488 | 264 881 | 43.41 | 603 313 |
RR of diabetes SA2 | Change from 1.31 to 1.12 | 30 | 0.0488 | 303 986 | 36.86 | 433 247 |
RR of diabetes SA3 | Change from 1.31 to 1.73 | 2 | 0.2029 | 31 591 | 4.57 | 59 793 |
Utility decrement diabetes | Change from 0.131 to 0.015 | 30 | 0.0488 | 362 956 | 40.16 | 440 154 |
Disutility of treatment | Change from 0 to 0.001 | 6 | 0.1445 | 108 849 | 13.01 | 151 389 |
↵a Results per 10 000 persons.
↵b Strategy with the largest incremental net benefit is the ‘optimum’ at this threshold, yielding the greatest QALY gain while accounting for the opportunity cost of scarce healthcare resources.
↵c Based on £20 000 per QALY gained.
↵d Initiate treatment with statins, reduce from 0.683 to 0.3415, and with antihypertensives, reduce from 0.565 to 0.2825 (invitation-based strategies).
↵e Stay on statin medication, 1 year: 0.8614 to 0.4307, 5 years: 0.6877 to 0.343875; stay on antihypertensive medication, 1 year: 0.7055 to 0.35275, 5 years: 0.4905 to 0.24525. CVD = cardiovascular disease. QALY = quality-adjusted life year. RR = relative risk. SA1 = sensitivity analysis 1, SA2 = sensitivity analysis 2. SA3 = sensitivity analysis 3.