Is mass screening for coeliac disease a wise use of resources? A health economic evaluation

BMC Gastroenterology

Table 3 Cost-effectiveness of a coeliac disease screening – base case and sensitivity analyses

	Screening		No screening		Incremental costIncremental cost		ICER
	Cost	QALY	Cost	QALY	Cost	QALY	ICER
Base case
Discount	76,620	24.70	72,264	24.60	4356	0.11	40,105
No discount	179,858	57.45	174,236	57.27	5622	0.18	31,948
Sensitivity analyses^a
(1) Double cost of screening	79,209	24.70	72,265	24.60	6944	0.11	63,490
(2) Not all cases diagnosed in screening	76,532	24.69	72,265	24.60	4267	0.10	42,874
(3a) Compliance of 96% to gluten-free diet	72,375	24.86	69,831	24.68	2544	0.18	14,068
(3b) Compliance of 78% to gluten-free diet	80,015	24.58	74,211	24.53	5805	0.05	114,212
(4a) No increase in mortality due to CD	77,347	24.94	73,011	24.84	4336	0.10	42,764
(4b) Hazard ratio of 1.60 for all states	75,594	24.38	71,263	24.37	4331	0.10	42,440
(4c) Hazard ratio of 1.60 for states A, B, C, and E and 1.10 for state D	76,794	24.76	72,248	24.59	4546	0.17	26,692
(5a) Doubling transition probabilities from state A to states B, C, and D	76,620	24.70	73,414	24.52	3206	0.19	17,278
(5b) Halving transition probabilities from state A to states B, C, and D	76,620	24.70	70,992	24.68	5629	0.03	195,366
(6) Halving the transition probabilities to diagnosis for symptomatic undiagnosed states	76,620	24.70	74,172	23.93	2448	0.78	3145
(7) 0.05 lower QALY scores for states A and B	76,620	24.70	72,265	24.00	4356	0.71	6172

ICER incremental cost-effectiveness ratio, QALY quality-adjusted life year. Costs are measured in euros
^aA discount of 3% for costs and QALYs are assumed for all sensitivity analyses

ISSN: 1471-230X