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Table 3 Cost-effectiveness of IVIG for severe sepsis/septic shock using the best-fitting and alternative synthesis models of effectiveness evidence (see Table 2 for detailed specification of the models)

From: Intravenous immunoglobulin for severe sepsis and septic shock: clinical effectiveness, cost-effectiveness and value of a further randomised controlled trial

(Best-fitting model, M1) Fixed-effect model estimate (IVIG/IVIGAM compared with albumin) considering 3 days duration of IVIG therapy

Probability of being cost-effective for cost-effectiveness threshold

Treatment

Mean cost

Mean QALY

ICER

£20,000/QALY

£30,000/QALY

IVIG

£54,901

4.35

£20,850

0.505

0.789

Standard care

£45,593

3.90

 

0.495

0.211

(Alternative model M2) Random-effects model estimate (IVIG/IVIGAM compared with albumin)

 

Treatment

Mean cost

Mean QALY

ICER

£20,000/QALY

£30,000/QALY

IVIG

£57,200

4.62

£16,177

0.597

0.707

Standard care

£45,593

3.90

 

0.403

0,295

(Alternative model M3) Random-effects model (IVIG/IVIGAM compared with albumin/no treatments) considering Jadad score = 5

 

Treatment

Mean cost

Mean QALY

ICER

£20,000/QALY

£30,000/QALY

IVIG

£55,238

4.39

£19,968

0.502

0.611

Standard care

£45,593

3.90

 

0.498

0.389

(Alternative model M4a) Random-effects model (IVIG/IVIGAM compared with albumin/no treatment) considering a sample size of 339

 

Treatment

Mean cost

Mean QALY

ICER

£20,000/QALY

£30,000/QALY

IVIG

£53,518

4.18

£28,520

0.404

0.514

Standard care

£45,593

3.90

 

0.596

0.486

(Alternative model M4b) Random-effects model (IVIG/IVIGAM compared with albumin/no treatment) considering a sample size of infinity

 

Treatment

Mean cost

Mean QALY

ICER

£20,000/QALY

£30,000/QALY

IVIG

£50,024

3.76

Dominated

0.275

0.348

Standard care

£45,593

3.90

 

0.725

0.652