Pempa Pempa
Health Technology Assessment Practitioner  |  Bhutan

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

Asked: 05 Jun 2019  |   1353
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 https://www.herc.ox.ac.uk/downloads/decision-modelling-for-health-economic-evaluation

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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Mark Jit

Professor
London School of Hygiene & Tropical Medicine, UK

Alec Morton

Professor
Professor, University of Strathclyde, Glasgow
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