***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To assess the incremental cost and cost-effectiveness of continuous and discontinuous regimens of bevacizumab ( Avastin ) and ranibizumab ( Lucentis ) for neovascular age-related macular degeneration ( nAMD ) from a UK National Health Service ( NHS ) perspective . Design A within-trial cost-utility analysis with a 2-year time horizon , based on a multicentre factorial , non-inferiority r and omised controlled trial . Setting 23 hospital ophthalmology clinics . Participants 610 patients aged ≥50 years with untreated nAMD in the study eye . Interventions 0.5 mg ranibizumab or 1.25 mg bevacizumab given continuously ( monthly ) or discontinuously ( as-needed ) for 2 years . Main outcome measures Quality -adjusted life-years ( QALYs ) . Results Total 2-year costs ranged from £ 3002/patient ( $ 4700 ; 95 % CI £ 2601 to £ 3403 ) for discontinuous bevacizumab to £ 18 590/patient ( $ 29 106 ; 95 % CI £ 18 258 to £ 18 922 ) for continuous ranibizumab . Ranibizumab was significantly more costly  than bevacizumab for both continuous ( + £ 14 989/patient ( $ 23 468 ) ; 95 % CI £ 14 522 to £ 15 456 ; p<0.001 ) and discontinuous treatment ( + £ 8498 ( $ 13 305 ) ; 95 % CI £ 7700 to £ 9295 ; p<0.001 ) , with negligible difference in QALYs . Continuous ranibizumab would only be cost-effective compared with continuous bevacizumab if the NHS were willing to pay £ 3.5 million ( $ 5.5 million ) per additional QALY gained . Patients receiving continuous bevacizumab  accrued higher total costs ( + £ 599 ( $ 938 ) ; 95 % CI £ 91 to £ 1107 ; p=0.021 ) than those receiving discontinuous bevacizumab , but also accrued non-significantly more QALYs ( + 0.020 ; 95 % CI −0.032 to 0.071 ; p=0.452 ) . Continuous bevacizumab therefore cost £ 30 220 ( $ 47 316 ) per QALY gained versus discontinuous bevacizumab . However , bootstrapping demonstrated that if the NHS is willing to pay £ 20 000/QALY gained , there is a 37 % chance that continuous bevacizumab  is cost-effective versus discontinuous bevacizumab . Conclusions Ranibizumab  is not cost-effective compared with bevacizumab , being substantially more costly and producing little or no QALY gain . Discontinuous bevacizumab is likely to be the most cost-effective of the four treatment strategies evaluated in this UK trial , although there is a 37 % chance that continuous bevacizumab is cost-effective . Trial registration number IS RCT N92166560 Background : Due to the high prevalence of overweight and obesity there is a need to identify cost-effective approaches for weight loss in primary care and community setting s. Objective : We evaluated the cost effectiveness of two weight loss programmes of 1-year duration , either st and ard care ( SC ) as defined by national guidelines , or a commercial provider ( Weight Watchers ) ( CP ) . Design : This analysis was based on a r and omised controlled trial of 772 adults ( 87 % female ; age 47.4±12.9 years ; body mass index 31.4±2.6 kg m−2 ) recruited by health professionals in primary care in Australia , United Kingdom and Germany . Both a health sector and societal perspective were adopted to calculate the cost per kilogram of weight loss and the ICER , expressed as the cost per quality adjusted life year ( QALY ) . Results : The cost per kilogram of weight loss was USD122 , 90 and 180 for the CP in Australia , the United Kingdom and Germany , respectively . For SC the cost was USD138 , 151 and 133 , respectively . From a health-sector perspective , the ICER for the CP relative to SC was USD18 266 , 12 100 and 40 933 for Australia , the United Kingdom and Germany , respectively . Corresponding societal ICER figures were USD31 663 , 24 996 and 51 571 . Conclusion : The CP was a cost-effective approach from a health funder and societal perspective . Despite participants in the CP group attending two to three times more meetings than the SC group , the CP was still cost effective even including these added patient travel costs . This study indicates that it is cost effective for general practitioners ( GPs ) to refer overweight and obese patients to a CP , which may be better value than expending public funds on GP visits to manage this problem OBJECTIVE To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers . METHODS This cost-effectiveness analysis is based on a r and omized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network . The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics . Four hundred and fifteen stimulant abusers were assigned to usual care ( N=206 ) or usual care plus abstinence-based incentives ( N=209 ) for 12 weeks . Participants r and omized to the incentive condition earned the chance to draw for prizes for su bmi tting substance negative sample s ; the number of draws earned increased with continuous abstinence time . Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care . The primary patient outcome was longest duration of confirmed stimulant abstinence ( LDA ) . Unit costs were obtained via surveys administered at the eight participating clinics . Re source utilizations and patient outcomes were obtained from the clinical trial . Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information . RESULTS The incremental cost to lengthen the LDA by 1 week was 258 US dollars ( 95 % confidence interval , 191 - 401 US dollars ) . Sensitivity analyses on several key parameters show that this value ranges from 163 to 269 US dollars . CONCLUSIONS Compared with the usual care group , the incentive group had significantly longer LDAs and significantly higher costs Objectives : To determine whether , from a healthcare perspective , a specific occupational health intervention is cost effective in reducing sickness absence when compared with usual care in occupational health in workers with high risk of sickness absence . Methods : Economic evaluation alongside a r and omised controlled trial . 418 workers with high risk of sickness absence from one corporation were r and omised to intervention ( n = 209 ) or to usual care ( n = 209 ) . The subjects in the intervention group were invited to occupational health service for a consultation . The intervention included , if appropriate , a referral to specialist treatment . Register data of sickness absence were available for 384 subjects and question naire data on healthcare costs from 272 subjects . Missing direct total cost data were imputed using a two-part regression model . Primary outcome measures were sickness absence days and direct healthcare costs up to 12 months after r and omisation . Cost effectiveness ( CE ) was expressed as an incremental CE ratio , CE plane and CE acceptability curve with both available direct total cost data and missing total cost data imputed . Results : After one year , the mean of sickness absence was 30 days in the usual care group ( n = 192 ) and 11 days less ( 95 % CI 1 to 20 days ) in the intervention group ( n = 192 ) . Among the employees with available cost data , the mean days of sickness absence were 22 and 24 , and the mean total cost € 974 and € 1049 in the intervention group ( n = 134 ) and in the usual care group ( n = 138 ) , respectively . The intervention turned out to be dominant — both cost saving and more effective  than usual occupational health care . The saving was € 43 per sickness absence day avoided with available direct total cost data , and € 17 with missing total cost data imputed . Conclusions : One year follow-up data show that occupational health intervention for workers with high risk of sickness absence is a cost effective use of healthcare re sources BACKGROUND Little is known about the cost-effectiveness of preventing mental disorders . AIMS To study the cost-effectiveness of care as usual plus minimal contact psychotherapy relative to usual care alone in preventing depressive disorder . METHOD An economic evaluation was conducted alongside a r and omised clinical trial . Primary care patients with sub-threshold depression were assigned to minimal contact psychotherapy plus usual care ( n=107 ) or to usual care alone  ( n=109 ) . RESULTS Primary care patients with sub-threshold depression benefited from minimal contact psychotherapy as it reduced the risk of developing a full-blown depressive disorder from 18 % to 12 % . In addition , this intervention had a 70 % probability of being more cost-effective than usual care alone . A sensitivity analysis indicated the robustness of these results . CONCLUSIONS Over 1 year adjunctive minimal contact psychotherapy  improved outcomes and generated lower costs . This intervention is therefore superior to usual care alone in terms of cost-effectiveness Purpose of the study : to examine the costs and cost-effectiveness of ‘ second-generation ’ telecare , in addition to st and ard support and care that could include ‘ first-generation ’ forms of telecare , compared with st and ard support and care that could include ‘ first-generation ’ forms of telecare . Design and methods : a pragmatic cluster-r and omised controlled trial with nested economic evaluation . A total of 2,600 people with social care needs participated in a trial of community-based telecare in three English local authority areas . In the Whole Systems Demonstrator Telecare Question naire Study , 550 participants were r and omised to intervention and 639 to control . Participants who were offered the telecare intervention received a package of equipment and monitoring services for 12 months , additional to their st and ard health and social care services . The control group received usual health and social care . Primary outcome measure : incremental cost per quality -adjusted life year ( QALY ) gained . The analyses took a health and social care perspective . Results : cost per additional QALY was £ 297,000 . Cost-effectiveness acceptability curves indicated that the probability of cost-effectiveness at a willingness-to-pay of £ 30,000 per QALY gained was only 16 % . Sensitivity analyses combining variations in equipment price and support cost parameters yielded a cost-effectiveness ratio of £ 161,000 per QALY . Implication s : while QALY gain in the intervention group was similar to that for controls , social and health services costs were higher . Second-generation telecare did not appear to be a cost-effective addition to usual care , assuming a commonly accepted willingness to pay for QALYs . Trial registration number : IS RCT N 43002091 BACKGROUND Uncertainty exists regarding the best management of patients with degenerative tears of the rotator cuff . OBJECTIVE To evaluate the clinical effectiveness and cost-effectiveness of arthroscopic and open rotator cuff repair in patients aged ≥ 50 years with degenerative rotator cuff tendon tears . DESIGN Two parallel-group r and omised controlled trial . SETTING Nineteen teaching and district general hospitals in the UK . PARTICIPANTS Patients ( n = 273 ) aged ≥ 50 years with degenerative rotator cuff tendon tears . INTERVENTIONS Arthroscopic surgery and open rotator cuff repair , with surgeons using their usual and preferred method of arthroscopic or open repair . Follow-up was by telephone question naire at 2 and 8 weeks after surgery and by postal question naire at 8 , 12 and 24 months after r and omisation . MAIN OUTCOME MEASURES The Oxford Shoulder Score ( OSS ) at 24 months was the primary outcome measure . Magnetic resonance imaging evaluation of the shoulder was made at 12 months after surgery to assess the integrity of the repair . RESULTS The mean OSS improved from 26.3 [ st and ard deviation ( SD ) 8.2 ] at baseline to 41.7 ( SD 7.9 ) at 24 months for arthroscopic surgery and from 25.0 ( SD 8.0 ) at baseline to 41.5 ( SD 7.9 ) at 24 months for open surgery . When effect sizes are shown for the intervention , a negative sign indicates that an open procedure is favoured . For the intention-to-treat analysis , there was no statistical difference between the groups , the difference in OSS score at 24 months was -0.76 [ 95 % confidence interval ( CI ) -2.75 to 1.22 ; p = 0.452 ] and the CI excluded the predetermined clinical ly important difference in the OSS of 3 points . There was also no statistical difference when the groups were compared per protocol ( difference in OSS score -0.46 , 95 % CI -5.30 to 4.39 ; p = 0.854 ) . The question naire response rate was > 86 % . At 8 months , 77 % of participants reported that shoulder problems were much or slightly better , and at 24 months this increased to 85 % . There were no significant differences in mean cost between the arthroscopic group and the open repair group for any of the component re source -use categories , nor for 
    Output:
    
Our review shows that missing data in within- RCT CEAs are still often inadequately h and led and the overall level of information provided to support the chosen methods is rarely satisfactory