Table 126Health economic evidence profile: Home-based MDT clinic (mid-length intervention) vs usual care in high risk patients

StudyApplicabilityLimitationsOther commentsIncremental costIncremental effectsCost-effectivenessUncertainty
Sahlen 2016290 [Sweden]Partially applicable(a)Potentially serious limitations(b)
  • Cost-utility analysis (health outcome: QALYs)
  • Within-trial analysis of a RCT study50
  • Population: adults with chronic heart failure with NYHA class III-IV symptoms and a marker of severity
  • Interventions:
    1. Usual care
    2. MDT - consisting of a heart failure nurse, palliative care nurse, cardiologist, palliative care physician, physiotherapist and occupational therapist
  • 6 month follow-up
2-1: Cost saving of £1,5172-1: 0.03 QALYs2 dominates 1 (more effective and less costly)
  • Uncertainty not reported for cost effectiveness
  • Conclusions robust to sensitivity analyses.

Abbreviations: QALY: quality-adjusted life years; RCT: randomised controlled trial

(a)

Single centre study from a county council hospital in Vӓsterbotten County, Sweden and therefore resource use and 2012 costs may not reflect current UK NHS context.

(b)

Short time horizon may not capture full costs and effects of the intervention. EQ-5D reported differently to the clinical trial evidence. Only minimal sensitivity analyses were carried out to quantify uncertainty.

From: 9, Referral and approach to care

Cover of Chronic Heart Failure in Adults
Chronic Heart Failure in Adults: Diagnosis and Management.
NICE Guideline, No. 106.
National Guideline Centre (UK).
Copyright © NICE 2018.

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