Pempa Pempa
Health Technology Assessment Practitioner  |  Bhutan

Plotting ICER result on cost-effectiveness plane and putting PSA in CEAC

Asked: 05 Jun 2019  |   710
Dear Expert, I have values for both the incremental cost and incremental DALY/QALY. How do I put them on cost-effectiveness plane or how do I plot them in graph, so that I get nice graph showing ICER result on cost-effectiveness plane? number 2: I have all the values from PSA. How do I put them in cost-effectiveness acceptability curve? Thank you.

Expert Replies:

Alec Morton

Professor  |  United Kingdom  |   Replied: 11 Jun 2019 at 17:37
Mark's answer is very helpful and I dont have much to add. But if you want more information on question (2) I would suggest that you look at "Decision Modelling for Health Economic Evaluation" by Briggs et al. Chapter 5 has a lot of useful information about computing the CEAC and related plots. You can find spreadsheets which give worked examples for the book and are free to download at

Mark Jit

Professor  |  United Kingdom  |   Replied: 11 Jun 2019 at 16:37
1) The standard method is to plot your results on the cost-effectiveness plane. This has incremental costs (compared to the null or no intervention scenario) on the x-axis and incremental health gains (eg. DALYs/QALYs) on the y-axis. If you like you can draw a line connecting this to the origin and put the ICER next to it. You can see a nice example in Figure 8.6 (page 265) of Drummond et al. Methods for the Economic Evaluation of Health Care Programmes.

2) You would need to compute the % of your PSA samples that lie below various thresholds, and then plot a graph with the different threshold values (ranging from $0 to some very high figure where close to 100% of samples are below the threshold) on the x-axis, and the % of samples below this value on the y-axis. Again take a look at pages 265-267 of Drummond et al.

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Alec Morton

Professor, University of Strathclyde, Glasgow

Mark Jit

London School of Hygiene & Tropical Medicine, UK
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