Cost-effectiveness

The base-case incremental cost-effectiveness ratio for insertable cardiac monitoring versus standard of care was $38,346 per QALY gained. The intervention produced 0.350 additional life-years and 0.305 additional QALYs per woman diagnosed with breast cancer. The lifetime model found NORS to be dominant because it improved health outcomes while reducing costs compared with no intervention. Insertable cardiac monitoring gained 0.176 QALYs per patient and avoided 53 additional strokes per 1,000 patients compared with standard of care. NORS gained an estimated 0.46 incremental QALYs over a lifetime horizon. NORS had estimated lifetime incremental costs of -C$25,405. In the deterministic base case, PAAP dominated usual care by lowering costs and increasing QALYs over five years. Average costs, uptake, and overtreatment costs will inform national dynamic transmission models for scale-up benefits. PAAP produced more QALYs than usual care in both the first year and later years. Some interface PPM-DOTS studies found the model cost-saving from a societal perspective. A direct PPM scale-up across large Indian cities was also cost-saving from a societal perspective. The review concludes that…