Cost-effectiveness outcomes
| Scenarios ranked according to increasing costs | Costs (95% CI) | QALYs (95% CI) | Incremental cost- effectiveness ratio | Incremental cost vs current practice (95% CI) | Incremental QALYs vs current practice (95% CI) | Net health benefit at £20 k/QALY (95% CI) | Net health benefit at £30 k/QALY (95% CI) | % cost-effective at £20 k/QALY | % cost-effective at £30 k/QALY |
|---|---|---|---|---|---|---|---|---|---|
| Current practice | 1854 (1607 to 2294) | 13.367 (12.415 to 14.243) | – | – | – | 13.275 (12.327 to 14.136) | 13.305 (12.358 to 14.171) | 36.0 | 28.4 |
| Cardiovascular risk assessment scenarios | |||||||||
| Old guidelines | 1999 (1753 to 2423) | 13.380 (12.426 to 14.243) | 11 797 | 145 (89 to 194) | 0.012 (−0.017 to 0.039) | 13.280 (12.325 to 14.142) | 13.313 (12.359 to 14.174) | 29.0 | 24.6 |
| Current guidelines | 2064 (1823 to 2486) | 13.381 (12.426 to 14.250) | (40 089 Extendedly dominated) | 210 (136 to 277) | 0.014 (−0.026 to 0.047) | 13.278 (12.318 to 14.144) | 13.312 (12.354 to 14.178) | 22.6 | 19.0 |
| Alternative guidelines | 2107 (1868 to 2531) | 13.380 (12.428 to 14.248) | Absolutely dominated | 254 (174 to 326) | 0.013 (−0.029 to 0.049) | 13.275 (12.318 to 14.138) | 13.310 (12.354 to 14.172) | 9.0 | 10.2 |
| Subtotal: | 60.6 | 53.8 | |||||||
| Polypill scenarios | |||||||||
| Polypill age 60+ | 3082 (2851 to 3591) | 13.407 (12.452 to 14.284) | 39 945 | 1229 (1134 to 1296) | 0.039 (−0.013 to 0.085) | 13.253 (12.294 to 14.123) | 13.304 (12.346 to 14.177) | 2.8 | 12.4 |
| Polypill age 55+ | 3331 (3104 to 3743) | 13.406 (12.452 to 14.272) | Absolutely dominated | 1478 (1375 to 1551) | 0.039 (−0.024 to 0.091) | 13.239 (12.280 to 14.096) | 13.295 (12.335 to 14.155) | 0.4 | 3.2 |
| Polypill age 50+ | 3523 (3394 to 3919) | 13.404 (12.447 to 14.261) | Absolutely dominated | 1669 (1561 to 1748) | 0.037 (−0.032 to 0.095) | 13.228 (12.269 to 14.076) | 13.286 (12.329 to 14.138) | 0.2 | 1.6 |
| Polypill age 45+ | 3645 (3419 to 4041) | 13.401 (12.444 to 14.258) | Absolutely dominated | 1791 (1682 to 1873) | 0.034 (−0.038 to 0.097) | 13.219 (12.260 to 14.070) | 13.280 (12.321 to 14.131) | 0.0 | 0.4 |
| Polypill age 40+ | 3686 (3462 to 4083) | 13.400 (12.444 to 14.256) | Absolutely dominated | 1833 (1721 to 1915) | 0.033 (−0.037 to 0.097) | 13.216 (12.258 to 14.066) | 13.277 (12.320 to 14.128) | 0.0 | 0.2 |
| Subtotal: | 3.4 | 17.8 | |||||||
Costs (in 2012/2013 UK pounds), QALYs and net health benefits (in QALYs) are provided as mean from the base-case analysis with 95% CI from the probabilistic sensitivity analysis. Incremental cost-effectiveness ratios are given, calculated by comparison of undominated strategies. Absolutely dominated indicates a less effective and more costly programme than the previous programme. Extendedly dominated indicates a programme that is less costly than the next not absolutely dominated programme, but also has a larger incremental cost-effectiveness ratio than this next programme.
CI, credible interval; QALYs, quality-adjusted life-years.