Outcome Difference in risk N if implemented Health Economic Impact QALY Economic Total Economic Impact between control at 65% service on health service impact impact on and treatment cost per costs if per QALYS if person or implemented person implemented day Primary Unplanned doctors visit -0.3 -6,347 -$130 -$0.8m - - -$0.8m (mean) Oral corticosteroid -0.09 -2,327 -$9 <-$0.1m - - <-$0.1m use (mean) Secondary Neonatal -53% -1,920 -$11,884 -$23m - - -$23m hospitalisation Change in +$2m intervention costs - Totals -$24m -$22m Columns may not sum due to rounding. Negative values are savings in the calculations. ED = emergency department. Health Health Service service/outcome Explanation and costing assumptions Reference or Outcome cost per person or day Unscheduled doctor visits were in primary care. Confirmed through interview. Unplanned doctor Service cost: The cost is based on MBS 597, out of hours cost, to offset some of the missed visits -$130 savings in additional nursing and ancillary support. Costs of B2 agonists balance out due to overall different treatment profile, and are not thought to be economically salient. Oral Service cost: Cost of oral corticosteroids included as a primary outcome (raw material cost corticosteroid use -$9 http://www.aafp.org/afp/2011/0701/p40.html $9, PBS). No additional clinical costs (beyond GP visits). No QALY impairment http://www.pbs.gov.au/medicine/item/1916W-1917X-3152X for moderate asthma exacerbations resolved with oral corticosteroids.
Outcome Difference in risk between control and treatment N if implemented at 65% Health service cost per person or day Economic Impact on health service costs if implemented QALY impact per person Economic impact on QALYS if implemented Total Economic Impact Primary Unplanned doctors visit (mean) -0.3 -6,347 -$130 -$0.8m - - -$0.8m Oral corticosteroid use (mean) -0.09 -2,327 -$9 <-$0.1m - - <-$0.1m Secondary Neonatal hospitalisation -53% -1,920 -$11,884 -$23m - - -$23m Change in intervention costs Totals +$2m -$24m - -$22m Columns may not sum due to rounding. Negative values are savings in the calculations. ED = emergency department. Health Service or Outcome Health service/outcome cost per person or day Explanation and costing assumptions Reference Unplanned doctor visits Service cost: -$130 Unscheduled doctor visits were in primary care. Confirmed through interview. The cost is based on MBS 597, out of hours cost, to offset some of the missed savings in additional nursing and ancillary support. Oral corticosteroid use Service cost: -$9 Costs of B2 agonists balance out due to overall different treatment profile, and are not thought to be economically salient. Cost of oral corticosteroids included as a primary outcome (raw material cost $9, PBS). No additional clinical costs (beyond GP visits). No QALY impairment for moderate asthma exacerbations resolved with oral corticosteroids. http://www.aafp.org/afp/2011/0701/p40.html http://www.pbs.gov.au/medicine/item/1916W-1917X-3152X
Supplementary-Appendix-B-Economic-evaluation-of-investigator-initiated-clinical-trials-conducted-by-networks.docx