Background
Methods
Modelling framework
Parameter | Description |
---|---|
Type of economic evaluation | Cost-effectiveness and cost-utility analysis |
Modelled population | Preschool children (0–4 years of age) |
Exposure variables | 1) Safe storage of medicines 2) Safe storage of other household products |
Outcome event | Unintentional ingestion of potential toxic substance |
Unit of analysis | Household with one child |
Perspective on costs | UK NHS and Personal and Social Services (PSS) |
Health outcomes (Utilities) | Quality Adjusted-Life Year (QALY) |
Base year for calculating costs/prices | 2012 |
Currency unit | British pound (£) |
Hypothetical cohort size | 100,000 households |
Effectiveness evidence | Network meta-analyses (Achana et al 2015) [9] |
Comparator or reference intervention | Usual care intervention |
Number of intervention strategies | 7 |
Number of health states (Markov model) | 6 |
Cycle length for Markov model | 1 year |
Half-cycle correction | No |
Time horizon | 100 years |
Discount rate for costs | 3.5 % |
Discount rate for utilities | 3.5 % |
Model structure
Stage 1: Intervention model
Stage 2: Preschool model
Parameter | Description | Data sources | Derivation of required probabilities | Point estimate (standard error (SE) | Distribution |
---|---|---|---|---|---|
pSafe
| Baseline prevalence of safe storage of medicines | Case control study of risk and protective factors for poison injuries in under 5 year olds (Kendrick et al, paper om press). | Number of households with safe storage of medicines/Total number of households selected as community controls in case control of risk and protective factors in children under 5 years old (Kendrick et al, paper om press). | 1527/2033 = 0.75 | Beta |
pAccept
| Probability of accepting the intervention | Saramago, Cooper et al., 2015 [14] | Assumption based on value in Functional smoke alarm model. Assumed the same for all interventions. | 0.90 | Fixed |
pEff
| Probability of safe storage of medicines given the intervention | Achana et al., 2015 [9] | (1) Usual care (2) Education (3) Provision of low cost/free low cost/free equipment (4) Education + provision of low cost/free equipment (5) Education + equipment + home safety inspection (6) Education + equipment + fitting (7) Education + equipment + home safety inspection + fitting | 0.87 (95%CrI 0.56, 0.98) 0.90 (95%CrI 0.61, 0.98) 0.93 (95%CrI 0.65, 0.99) 0.94 (95%CrI 0.74, 0.99) 0.90 (95%CrI 0.56, 0.99) 0.90 (95%CrI 0.59, 0.98) 0.93 (95%CrI 0.66, 0.99) | Posterior distribution of absolute intervention effects from network meta-analysis. |
pIngest
| Probability of unintentional exposure/ingestion | Orton et al., 2014 [10] Tyrrell et al., 2012 [33] Office for National Statistics, 2013 [34] | Orton et al [10] – incidence of poisonings in the UK for period 2005–2009 is 30.1 (95 % CI 29.1–31.2). Mid-year population estimates of under 5 year olds in the UK in 2012 = 3996400 [34]. Hence number of poisoning cases = (30.1*3996400)/10000 = 12029. The numerator (n = 12029*0.6 = 7217) was derived based on information in [33] suggesting that 1316 (60 %) of the 2193 medically reported poisonings identified in the THIN database were due to ingestion of a medicinal substance. | 7217/3996400 = 0.001806 | Beta |
orIngest
| Relative risk of exposure to a medicinal substance comparing children with a poisoning to community controls. | Case control study of risk and protective factors for poison injuries in under 5 year olds (unpublished study) | Community controlled adjusted analysis odds ratio for safe storage versus no safe storage = 1.83 (95 % CI 1.38–2.42) | Log odds ratio (SE) = -0.604 (0.143) | Normal |
pAmb
| Probability of using emergency ambulance. | Hospital Episode Statistics, 2012 | Hospital Episode Statistics (2012b): 24.2 % of all cases arrived by emergency transfer (ambulance/helicopter). | 0.242 | Fixed |
pAdmit
| Probability of in-patient admission following a medicinal poisoning injury (ICD-10: X40-X44). | Hospital Episode Statistics, 2013 [35] Office for National Statistics, 2013 [34] | 4546/7217 = 0.63 | Beta | |
pSevere
| Probability of severe poisoning injury | Mowry et al., 2013 [36] | NPDS 2012 report [36], Table 13, page 968) 1.91 % of major poisoning cases (across all age groups) resulted in a chronic health condition. Numerator = 0.019* 4546 = 87. | 87/4546 = 0.0191 | Beta |
pFatal
| Probability of fatal poisoning injury. | Office for National Statistics, 2012 [37] | UK mortality statistics [37]. 1 fatality from medicinal poisonings in 0–4 years old (assumed fatality occur after a long inpatient stay). | 1/86 = 0.0116 | Beta |
pDead
| UK mortality statistics | Office for National Statistics, 2010 [38] | UK mortality statistics [38] | Normal |
Parameter | Description | Data sources | Derivation of required probabilities | Point estimate (standard error (SE) | Distribution |
---|---|---|---|---|---|
pSafe
| Baseline prevalence of safe storage of non-medicines | Kendrick et al (paper om press) | Number of households with safe other household products/Total number of households selected as community controls in case control of risk and protective factors in children under 5 years old (Kendrick et al, paper om press). | 948/1138 = 0.83 | Beta |
pAccept
| Probability of accepting the intervention | Saramago, Cooper et al., 2015 [14] | Assumption based on value in Functional smoke alarm model [14]. Assumed the same for all interventions. | 0.90 | Fixed |
pEff
| Probability of safe storage of medicines given the intervention | Achana et al., 2015 [9] | (1) Usual care (2) Education (3) Provision of low cost/free low cost/free equipment (4) Education + provision of low cost/free equipment (5) Education + equipment + home safety inspection (6) Education + equipment + fitting (7) Education + equipment + home safety inspection + fitting | 0.62 (95%CrI 0.34–0.81) 0.66 (95%CrI 0.38–0.87) 0.36 (95%CrI 0.00–1.00) 0.78 (95%CrI 0.48–0.94) 0.80 (95%CrI 0.51–0.94) 0.68 (95%CrI 0.32–0.90) 0.50 (95%CrI 0.00–1.00) | Posterior distribution of absolute intervention effects from network meta-analysis. |
pIngest
| Probability of unintentional exposure/ingestion | Orton et al., 2014 [10] Tyrrell et al., 2012 [33] Office for National Statistics, 2013 [34] | 4812/3996400 = 0.001204 | Beta | |
orIngest
| Relative risk of exposure to a medicinal substance comparing children with a poisoning to community controls. | Case control study of risk and protective factors for poison injuries in under 5 year olds (unpublished study) | Community controlled adjusted analysis odds ratio for safe storage versus no safe storage = 0.77 (95 % CI 0.59–0.99) | Log odds ratio (SE) = 0.2614 (0.132) | Normal |
pAmb
| Probability of using emergency ambulance. | Hospital Episode Statistics, 2012 | Hospital Episode Statistics (2012b): 24.2 % of all cases arrived by emergency transfer (ambulance/helicopter). | 0.242 | Fixed |
pAdmit
| Probability of in-patient admission following a medicinal poisoning injury (ICD-10: X40-X44). | Hospital Episode Statistics, 2013 [35] Office for National Statistics, 2013 [34] | 1597/4812 = 0.3318 | Beta | |
pSevere
| Probability of severe poisoning injury | Mowry et al., 2013 [36] | NPDS 2012 report [36], Table 13, page 968) 1.91 % of major poisoning cases (across all age groups) resulted in a chronic health condition. Numerator = 0.019* 1597 = 30. | 30/1597 = 0.0191 | Beta |
pFatal
| Probability of fatal poisoning injury. | Office for National Statistics, 2012 [37] | UK mortality statistics [37]. 1 fatality from medicinal poisonings in 0–4 years old (assumed fatality occur after a long inpatient stay). | 1/30 = 0.033 | Beta |
pDead
| UK mortality statistics | Office for National Statistics, 2010 [38] | UK mortality statistics [38] | Normal |
Stage 3: Long-term model
Implementation
Parameter | Description | Data sources | Derivation of required cost information | Point estimate (standard error (SE)) | Distribution |
---|---|---|---|---|---|
Intervention costsa | |||||
cFixed | Fixed cost of setting up an intervention scheme for 100 000 households | Saramago et al. 2014 [14] | Saramarago Cooper et al. [14] | £79,529 | Fixed |
cAccept | Cost of accepting intervention | Assumption | £0.40 | Fixed | |
cTravel | Travel time and costs | Travel time and costs Nottingham home safety equipment schemeb hourly rate including on costs and vehicle costs is £25 (estimate obtained through personal communication) to install 5 items of safety equipment. We allocated 1/5 th of hourly rate to poisoning prevention activities. | £5.00 | Fixed | |
Intervention schemes | |||||
cInter1 | Usual care | No cost associated with usual care as no intervention is provided. | £0.00 | Fixed | |
cInter2 | Education | Estimate based on 5 min of health visitors time costing £44 (interquartile rage £33–£54) [19]. This assumes education is provided during contact for other reasons (e.g. child health surveillance contact). No travel costs are included as it is assumed contact either occurs in clinic or during home visit for other reasons. | £3.67 | ||
cInter3 | Free or low cost safety equipment. | 2x kitchen cabinet locks (based on providing one pop-It Lock™ costing £2.65 and one magnetic lock costing £4.80 each plus vat). This assumes locks are provided during contact for other reasons (e.g. child health surveillance contact). No travel costs are included as it is assumed contact either occurs in clinic or during home visit for other reasons. | £7.45 | Fixed | |
cInter4 | Education + equipment | Cost of education and two cabinet locks = £3.76 + £7.45. This assumes education and locks are provided during contact for other reasons (e.g. child health surveillance contact). No travel costs are included as it is assumed contact either occurs in clinic or during home visit for other reasons. | £11.12 | Fixed | |
cInter5 | Education + equipment + home safety inspection | Cost of education, two cabinet locks, home safety inspection and travel = £3.67 + £7.45 + £3.67 + £4.99. This assumes education, home safety inspection and locks are provided by a health visitor during contact covering prevention of a range of injuries, of which poison prevention is a part. It assumes poison prevention education and home safety inspection each takes 5 min of health visitor time. | £19.78 | Fixed | |
cInter6 | Education + equipment + fitting | Education + equipment + fitting Cost of education, two cabinet locks and fitting of two locks (assumed takes 5 min of safety equipment fitters time at £25 per hour) and travel = £3.67 + £7.45 + £2.08 + £4.99. This assumes education is provided by a health visitor during a contact for other reasons (e.g. child health surveillance) and locks and fitting of locks are provided by a safety equipment scheme during contact covering prevention of a range of injuries, of which poison prevention is a part. It assumes poison prevention education takes 5 min of health visitor time and fitting of locks takes 5 min of safety equipment fitters’ time at £25 per hour. | £18.19 | Fixed | |
cInter7 | Education + equipment + home inspection + fitting | Education + equipment + home inspection + fitting Cost of education, two cabinet locks, home inspection, fitting of locks and travel = £3.67 + £7.45 + £3.67 + £2.08 + £4.99. This assumes education is provided by a health visitor during a contact for other reasons (e.g. child health surveillance) and home safety inspection, locks and fitting of locks are provided by a safety equipment scheme during contact covering prevention of a range of injuries, of which poison prevention is a part. It assumes poiso n prevention education takes 5 min of health visitor time and the home safety inspection and fitting of locks each take 5 min of safety equipment fitters’ time at £25 per hour. | £21.86 | Fixed | |
Healthcare costs (Hospital and primary care costs) | |||||
cAmb | Cost of emergency transfers | PSSRU [19] | £263 (SE = £21.48) | Gamma | |
cED1 | Cost of emergency department treatment of cases not leading to hospital inpatient stay (minor injury) | PSSRU [19] | £112 (SE = £27.41) | Gamma | |
cED2 | Cost of emergency department treatment for cases leading to hospital inpatient stay (major injury) | PSSRU [19] | £146 (SE = £42.22) | Gamma | |
cAdmit1 | Cost of a non-elective short (<2 days) inpatient admission | PSSRU [19] | £586 (SE = £223.70) | Gamma | |
cAdmit2 | Cost of a non-elective long (≥2 days) inpatient admission | PSSRU [19] | £2461 (SE = £810.37) | Gamma | |
cChro | Annual cost of chronic ill-health | HALO study (Nicholl et al.: The Long Term Health and Healthcare Outcomes of Accidental Injury (The HALO Study) Final Report, (Unpublished)) | £386.42 (SE = £96.72) | Gamma | |
cFatal | Cost of fatal injury | Saramago et al., 2014 [14] | £205.50 | Fixed | |
cGP | Cost of 11.7 min GP consultation | PSSRU [19] | £43 | Fixed |
Parameter | Description | Source | Point estimate (standard error) | Distribution |
---|---|---|---|---|
uPop
| UK non-injured population utilities | [21] | <25 years 0.94 (SE = 0.12) 25–34 years 0.93 (SE = 0.15) 35–44 years 0.91 (SE = 0.16) 45–54 years 0.85 (SE = 0.25) 55–54 years 0.80 (SE = 0.26) 65–74 years 0.78 (SE = 0.26) ≥75 years 0.73 (SE = 0.27) | Normal |
uMinor
| Utility deficit for minor injury | 0.03 (SE = 0.003) | Beta | |
uModerate
| Utility deficit for moderate injury | Utility decrement 0.046 for poisoning injury [22] | 0.046 (SE = 0.0046) | Beta |
uSevere
| Utility deficit for severe injury | Utility decrement 0.046 for poisoning injury [22] and decrement associated with injury of 0.1 from the HALO study | 0.146 (SE = 0.0146) | Beta |
uChronic
| Utility deficit associated with chronic injury per year | HALO Study (Nicholl et al. The Long Term Health and Healthcare Outcomes of Accidental Injury (The HALO Study) Final Report, (Unpublished)) | 0.10 (SE = 0.025) | Beta |
Data sources
Probabilities
Costs
Intervention costs
Healthcare utilisation/treatment costs
Utilities
Results
Medicinal poisoning base case
Intervention | Expected benefits (Poison cases)a | Expected Costs (£)a | Incremental benefits (Poisoning avoided) a | Incremental Costs (£)a | ICER (£/Poisoning avoided) | Probability intervention is cost-effective at £30,000/QALY | Probability intervention is cost-effective at £50,000/QALY |
---|---|---|---|---|---|---|---|
UC | 5.622 (4.988, 6.362) | 3617 (2372, 5398) | 0.000 | 0.000 | |||
E | 5.163 (4.422, 6.073) | 4937 (3737, 6606) | 0.453 (0.246, 0.617) | 1316 (1165, 1424) | 2888 (1990, 5774) | 0.811 | 0.6885 |
FE | 5.142 (4.398, 6.071) | 5777 (4554, 7452) | 0.472 (0.251, 0.632) | 2155 (1969, 2307) | 4553 (3284, 8892) | 0.181 | 0.279 |
E + FE | 5.137 (4.398, 6.056) | 6587 (5352, 8254) | 0.479 (0.274, 0.64) | 2973 (2749, 3172) | 6195 (4519, 11030) | 0.007 | 0.0315 |
E + FE + HSI | 5.176 (4.429, 6.105) | 8541 (7248, 10250) | 0.443 (0.219, 0.616) | 4926 (4576, 5261) | Dominated | 0.000 | 0.000 |
E + FE + F | 5.168 (4.421, 6.076) | 8178 (6899, 9895) | 0.449 (0.24, 0.627) | 4566 (4243, 4878) | Dominated | 0.000 | 0.000 |
E + FE + HSI + F | 5.148 (4.401, 6.071) | 8998 (7691, 10740) | 0.468 (0.259, 0.634) | 5382 (4999, 5747) | Dominated | 0.000 | 0.000 |
Intervention | Expected benefits (QALY)a | Expected Costs (£)a | Incremental benefits (QALY)a | Incremental Costs (£)a | ICER (£/QALY) | Probability intervention is cost-effective at £30,000/QALY | Probability intervention is cost-effective at £50,000/QALY |
---|---|---|---|---|---|---|---|
UC | 25056.559 (25039.293, 25073.828) | 4169 (2872, 6045) | 0.828 | 0.301 | |||
E | 25056.578 (25039.328, 5073.855) | 5435 (4197, 7271) | 0.031 (0.015, 0.059) | 1273 (1110, 1398) | 41330 (20007, 91534) | 0.172 | 0.698 |
FE | 25056.578 (25039.322, 5073.855) | 6270 (5027, 8099) | 0.031 (0.016, 0.061) | 2111 (1926, 2275) | Dominated | 0.000 | 0.002 |
E + FE | 25056.578 (25039.328, 5073.857) | 7089 (5829, 8921) | 0.032 (0.017, 0.062) | 2927 (2701, 3132) | 90615 (46258, 184517) | 0.000 | 0.000 |
E + FE + HSI | 25056.578 (25039.326, 5073.857) | 9051 (7737, 10930) | 0.030 (0.015, 0.059) | 4881 (4541, 5227) | Dominated | 0.000 | 0.000 |
E + FE + F | 25056.578 (25039.326, 5073.855) | 8695 (7392, 10570) | 0.030 (0.015, 0.06) | 4522 (4209, 4844) | Dominated | 0.000 | 0.000 |
E + FE + HSI + F | 25056.580 (25039.328, 5073.857) | 9506 (8166, 11410) | 0.031 (0.016, 0.061) | 5338 (4954, 5717) | Dominated | 0.000 | 0.000 |
Medicinal poisonings sensitivity analyses
Expected QALYs | Expected Costs (£s) | Incremental QALYs | Incremental Costs (£s) | ICER (£s per QALY) | Probability intervention is cost-effective at £30,000/QALY | Probability intervention is cost-effective at £50,000/QALY | |
---|---|---|---|---|---|---|---|
SA1: Probability that intervention is effective changed from Posterior to the Predictive distribution of intervention effects and baseline rate | |||||||
UC | 25060 (25040, 25070) | 4169 (2872, 6045) | 0.850 | 0.453 | |||
E | 25060 (25040, 25070) | 5463 (4221, 7319) | 0.027 (0.001, 0.059) | 1298 (1108, 1498) | 47160 (19917, 1361570) | 0.150 | 0.540 |
FE | 25060 (25040, 25070) | 6300 (5032, 8163) | 0.028 (0.002, 0.06) | 2140 (1926, 2360) | 74625 (33405, 1498841) | 0.000 | 0.006 |
SA2: Baseline probability of safe storage changed from 75 % (KCS community controls) to 93 % (Patel et al 2008) | |||||||
UC | 25060 (25040, 25070) | 3158 (2030, 4720) | 0.998 | 0.867 | |||
E | 25060 (25040, 25070) | 4056 (2938, 5599) | 0.013 (0.006, 0.023) | 898 (824, 957) | 71065 (37747, 150605) | 0.002 | 0.133 |
FE | 25060 (25040, 25070) | 4302 (3184, 5850) | 0.013 (0.006, 0.024) | 1139 (1052, 1227) | 87285 (46839, 184910) | 0.000 | 0.000 |
SA3: Baseline probability of safe storage changed from 75 % (KCS community controls) to 50 % (Assumption) | |||||||
UC | 25060 (25040, 25070) | 4903 (3542, 7022) | 0.942 | 0.59 | |||
E | 25060 (25040, 25070) | 6885 (5585, 8921) | 0.037 (0.017, 0.074) | 1985 (1816, 2121) | 53970 (26110, 126315) | 0.058 | 0.41 |
FE | 25060 (25040, 25070) | 8567 (7273, 10620) | 0.036 (0.014, 0.073) | 3671 (3458, 3861) | 101700 (48946, 270812) | 0.000 | 0.000 |
SA4: Probability intervention is accepted changed from 90 to 50 % (Assumption) | |||||||
UC | 25060 (25040, 25070) | 4169 (2872, 6045) | 0.979 | 0.745 | |||
E | 25060 (25040, 25070) | 5227 (3965, 7059) | 0.017 (0.008, 0.033) | 1061 (970.192, 1130) | 62195 (30779, 134700) | 0.02 | 0.254 |
FE | 25060 (25040, 25070) | 5693 (4429, 7527) | 0.017 (0.009, 0.034) | 1526 (1423, 1618) | 87356 (43931, 178215) | 0.000 | 0.001 |
SA5: Proportion admitted changed from 63 % (HSE, 2012) to 83.3 % (Phil Miller, personal communication) | |||||||
UC | 25060 (25040, 25070) | 5140 (3430, 7606) | 0.625 | 0.146 | |||
E | 25060 (25040, 25070) | 6358 (4711, 8776) | 0.036 (0.018, 0.066) | 1214 (1023, 1372) | 33630 (17180, 74539) | 0.374 | 0.852 |
FE | 25060 (25040, 25070) | 7202 (5548, 9627) | 0.036 (0.018, 0.068) | 2043 (1829, 2242) | 55495 (28904, 118515) | 0.000 | 0.002 |
SA6: Provided two pop it locks costing £2.65 per lock. | |||||||
UC | 25060 (25040, 25070) | 4169 (2872, 6045) | 0.828 | 0.298 | |||
E | 25060 (25040, 25070) | 5435 (4197, 7271) | 0.031 (0.015, 0.059) | 1273 (1110, 1398) | 41330 (20007, 91534) | 0.17 | 0.677 |
FE | 25060 (25040, 25070) | 5787 (4548, 7596) | 0.031 (0.016, 0.061) | 1629 (1462, 1772) | 51685 (25478, 107910) | 0.002 | 0.026 |
SA7: Provided two magnetic locks costing £4.80 per lock. | |||||||
UC | 25060 (25040, 25070) | 4169 (2872, 6045) | 0.828 | 0.301 | |||
E | 25060 (25040, 25070) | 5435 (4197, 7271) | 0.031 (0.015, 0.059) | 1273 (1110, 1398) | 41330 (20007, 91534) | 0.172 | 0.698 |
FE | 25060 (25040, 25070) | 6751 (5491, 8585) | 0.031 (0.016, 0.061) | 2592 (2383, 2779) | 82570 (41555, 16911) | 0.000 | 0.000 |
SA8: Increase the number of children in a household from 1 to 1.8 | |||||||
UC | 25060 (25040, 25070) | 4169 (2872, 6045) | 0.242 | 0.026 | |||
E | 25060 (25040, 25070) | 5435 (4197, 7271) | 0.031 (0.015, 0.059) | 1273 (1110, 1398) | 22960 (11118, 50852) | 0.755 | 0.962 |
FE | 25060 (25040, 25070) | 6270 (5027, 8099) | 0.031 (0.016, 0.061) | 2111 (1926, 2275) | 37210 (18628, 77301) | 0.003 | 0.012 |
SA9: Change incidence of medically reported poisonings from 30.1 to 44.9 per 10,000 person-years (rate of unintentional poisonings among under 5 year olds in the 4th most deprived quintile, Orton et al 2014 [10]) | |||||||
UC | 25060 (25040, 25070) | 5963 (3814, 8986) | 0.226 | 0.040 | |||
E | 25060 (25040, 25070) | 7110 (5119, 10070) | 0.06 (0.023, 0.179) | 1171 (911, 1355) | 19315 (6049, 54810) | 0.764 | 0.929 |
FE | 25060 (25040, 25070) | 7958 (5944, 10882) | 0.062 (0.024, 0.183) | 2002 (1721, 2215) | 32024.99 (10358, 85853) | 0.010 | 0.030 |
SA10: Change incidence of medically reported poisonings from 30.1 to 48.5 per 10,000 person-years (rate of unintentional poisonings among under 5 year olds in the 5th most deprived quintile, Orton et al 2014 [10]) | |||||||
UC | 25060 (25040, 25070) | 6380 (4239, 9731) | 0.172 | 0.031 | |||
E | 25060 (25040, 25070) | 7539 (5451, 10751) | 0.062 (0.024, 0.182) | 1148.5 (879, 1339) | 18275 (5599, 51842) | 0.818 | 0.938 |
FE | 25060 (25040, 25070) | 8375 (6296, 11590) | 0.063 (0.026, 0.189) | 1983 (1695, 2208) | 30759.974 (9962, 81214) | 0.010 | 0.030 |
SA11: Change estimate of standard error of utility decrements from 10 to 20 % of mean utility decrement value (assumption) | |||||||
UC | 25060 (25040, 25070) | 4131 (2842, 6011) | 0.800 | 0.800 | |||
E | 25060 (25040, 25070) | 5409 (4187, 7176) | 0.031 (0.015, 0.062) | 1289 (1125, 1426) | 40770 (19540, 92562) | 0.200 | 0.200 |
FE | 25060 (25040, 25070) | 6283 (5038, 8041) | 0.032 (0.016, 0.064) | 2152 (1960, 2332) | 66850 (32697, 141502) | 0.000 | 0.000 |
SA12: Change estimate of standard error of utility decrements from 10 to 50 % of mean utility decrement value (assumption) | |||||||
UC | 25060 (25040, 25070) | 4095 (2899, 6038) | 0.794 | 0.304 | |||
E | 25060 (25040, 25070) | 5382 (4238, 7217) | 0.031 (0.014, 0.062) | 1290 (1124, 1420) | 41265 (19450, 100505) | 0.206 | 0.696 |
FE | 25060 (25040, 25070) | 6257 (5082, 8100) | 0.032 (0.014, 0.063) | 2155 (1966, 2332) | 66825 (32717, 160607) | 0.000 | 0.000 |
Non-medicinal poisoning results
Intervention | Expected benefits (Poison cases)a | Expected Costs (£)a | Incremental benefits (Poison avoided) a | Incremental Costs (£)a | ICER (£/Poison avoided) | Probability intervention is cost-effective at £30,000/QALY | Probability intervention is cost-effective at £50,000/QALY |
---|---|---|---|---|---|---|---|
UC | 5.820 (4.848, 7.010) | 2242 (1563, 3272) | 1.000 | 1.000 | |||
E | 5.925 (4.862, 7.252) | 3544 (2839, 4626) | −0.106 (−0.272, −0.004) | 1305 (1231, 1389) | Dominated | 0.000 | 0.000 |
FE | 5.892 (4.855, 7.188) | 4650 (3916, 5774) | −0.016 (−0.343, 0.000) | 2414 (2202, 2656) | Dominated | 0.000 | 0.000 |
E + FE | 5.949 (4.865, 7.326) | 5979 (51644, 7124) | −0.123 (−0.304, −0.005) | 3728 (3365, 4128) | Dominated | 0.000 | 0.000 |
E + FE + HSI | 5.954 (4.86, 7.307) | 5736 (4933, 6861) | −0.129 (−0.311, −0.006) | 3491 (3153, 3867) | Dominated | 0.000 | 0.000 |
E + FE + F | 5.931 (4.862, 7.279) | 6291 (5458, 7421) | −0.110 (−0.279, −0.005) | 4035 (3622, 4480) | Dominated | 0.000 | 0.000 |
E + FE + HSI + F | 5.879 (4.864, 7.259) | 4101 (3390, 5181) | −0.034 (−0.352, 0.000) | 1864 (1717, 2040) | Dominated | 0.000 | 0.000 |
Intervention | Expected benefit (QALY)a | Expected Cost (£)a | Incremental benefit (QALY)a | Incremental Costs (£)a | ICER (£/QALY) a | Probability intervention is cost-effective at £30,000/QALY | Probability intervention is cost-effective at £50,000/QALY |
---|---|---|---|---|---|---|---|
UC | 25056.593 (25039.908, 25074.762) | 2483 (1737, 3582) | 1.000 | 1.000 | |||
E | 25056.580 (25039.900, 25074.754) | 3794 (3022, 4970) | −0.006 (−0.021, 0.000) | 1308 (1235, 1403) | Dominated | 0.000 | 0.000 |
FE | 25056.576 (25039.900, 25074.750) | 4901 (4109, 6097) | −0.001 (−0.027, 0.000) | 2414 (2206, 2665) | Dominated | 0.000 | 0.000 |
E + FE | 25056.578 (25039.898, 25074.754) | 6219 (5312, 7432) | −0.007 (−0.025, 0.000) | 3733 (3358, 4163) | Dominated | 0.000 | 0.000 |
E + FE + HSI | 25056.578 (25039.898, 25074.752) | 5978 (5086, 7180) | −0.007 (−0.026, 0.000) | 3497 (3153, 3885) | Dominated | 0.000 | 0.000 |
E + FE + F | 25056.580 (25039.898, 25074.754) | 6524 (5611, 7743) | −0.006 (−0.022, 0.000) | 4038 (3628, 4507) | Dominated | 0.000 | 0.000 |
E + FE + HSI + F | 25056.576 (25039.900, 25074.750) | 4354 (3583, 5490) | −0.001 (−0.027, 0.000) | 1864 (1722, 2056) | Dominated | 0.000 | 0.000 |