Table 4

One-way sensitivity analysis and effect on ICER

VariableBase caseSensitivity analysis rangeIncremental costIncremental QALYICERSource 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-up0.788 (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 QALY0.771–0.835
(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 baseline0.814% (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 probability0.025%0.239%£5798 (€6494)0.202£28 631 (€32 067)Expert opinion
Mortality probability incremental rise per year0.1%0.3%£5782 (€6476)0.033£175 290 (€196 325)Expert opinion
Operative mortality of ablation0.5%0.25% and 3%£5661 (€6340) and £5604 (€6276)0.046 and −0.078£123 562 (€138 389) and AAD dominatesRegistry
Baseline readmission probability per month1.332% (ablation) −1.666% (AAD)0.23%–2.273%£3204 (€3588)0.052£61 254 (€68 604)RCT*
Repeat ablation probability per month19% 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 ablation3%6.5%£5657 (€6335)0.039£144 093 (€161 384)Registry
Adverse event probability of AAD per month1.279%3.75%£5657 (€6335)0.042£134 711 (€150 876)Registry
Rate of amiodarone use in ablation group20%10% and 80%£5454 and £68790.038 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.