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To the Editor
The article by Wouters and colleagues1 presents an exhaustive overview on how quality-adjusted life years (QALYs) can be used in cost-effectiveness analysis. In this framework, the authors also mention the incremental cost-effectiveness ratio (ICER), which is the parameter typically used to express the results of a cost-effectiveness study. The article, however, does not discuss the net monetary benefit (NMB), which is another parameter used to express the results of a cost-effectiveness study.
The incremental cost (ΔC) and the incremental effectiveness (ΔE) are the two main parameters of pharmacoeconomics and cost-effectiveness analysis, along with the willingness-to-pay threshold (λ). The decision rule (eg, in the case of a favourable pharmacoeconomic result) is (ΔC/ΔE) < λ (equation 1), if based on the ICER, or (ΔE×λ−ΔC) > 0 (equation 2), if based on the NMB. Likewise, an unfavourable pharmacoeconomic result is when …
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