Variable | Base case | Sensitivity analysis range | Incremental cost | Incremental QALY | ICER | Source of sensitivity analysis range |
At end of 10 years | – | – | £4669 (€5229) | 0.063 | £74 469 (€84 405) | – |
At lifetime horizon (until entire cohort is in death state) | – | – | £4342 (€4863) | 0.063 | £68 853 (€77 115) | – |
Difference in HRQL at end of follow-up | 0.788 (ablation) −0.769 (AAD) | 0.802 | £5657 (€6335) | 0.007 | £815 610 (€913 483) | RCT |
Use of EQ-5D data from VANISH trial as HRQL contribution to calculate QALY | 0.771–0.835 (ablation) 0.769–0.824 (AAD) | 0.673–0.788 (ablation) 0.664–0.769 (AAD) | £5657 (€6335) | 0.097 | £58 208 (€65 193) | RCT |
Mortality probability at baseline | 0.814% (ablation)−0.839% (AAD) | 0.6% and 1.5% | £5492 (€6151) and £6001 (€6721) | 0.026 and 0.009 | £206 689 (€231 492) and £657 342 (€736 223) | Registry |
Difference in mortality probability | 0.025% | 0.239% | £5798 (€6494) | 0.202 | £28 631 (€32 067) | Expert opinion |
Mortality probability incremental rise per year | 0.1% | 0.3% | £5782 (€6476) | 0.033 | £175 290 (€196 325) | Expert opinion |
Operative mortality of ablation | 0.5% | 0.25% and 3% | £5661 (€6340) and £5604 (€6276) | 0.046 and −0.078 | £123 562 (€138 389) and AAD dominates | Registry |
Baseline readmission probability per month | 1.332% (ablation) −1.666% (AAD) | 0.23%–2.273% | £3204 (€3588) | 0.052 | £61 254 (€68 604) | RCT* |
Repeat ablation probability per month | 19% and 24% | 10% and 33% | £5893 (€6600) and £5339 (€5980) | 0.039 and 0.039 | £151 895 (€170 122) and £133 588 (€149 619) | Expert opinion |
Adverse event probability for ablation | 3% | 6.5% | £5657 (€6335) | 0.039 | £144 093 (€161 384) | Registry |
Adverse event probability of AAD per month | 1.279% | 3.75% | £5657 (€6335) | 0.042 | £134 711 (€150 876) | Registry |
Rate of amiodarone use in ablation group | 20% | 10% and 80% | £5454 and £6879 | 0.038 and 0.037 | £141 713 (€158 719) and £182 362 (€204 245) | Registry |
*Range of readmission probability selected from VTACH and SMS-VT to derive the largest difference in readmission between two treatments. Additionally, please see online supplementary appendix A for a two-way sensitivity analysis altering disutility.
AAD, antiarrhythmic drug; EQ-5D, EuroQol-5 Dimension; HRQL, health-related quality of life; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year; RCT, randomised clinical trial; SMS, Substrate Modification Study; VT, ventricular tachycardia.