A typical cost-effectiveness approach, in which the incremental cost-effectiveness ratio (ICER) was calculated, was used to model the costs and benefits (LYG) of the bisoprolol treatment in comparison with placebo.
Under the extended benefit scenario, the ICER of bisoprolol over placebo was:
1,917 with shared care and CIBIS II hospitalisation data,
2,043 with community care and CIBIS II hospitalisation data,
286 with shared care and assumptions on hospitalisation,
412 with community care and assumptions on hospitalisation,
199 with shared care and no discount rate,
301 with community care and no discount rate,
619 with shared care and 20% decrease in inpatient costs,
745 with community care and 20% decrease in inpatient costs,
47 with shared care and 20% increase in inpatient costs,
78 with community care and 20% increase in inpatient costs,
761 with shared care and 50% increase in drug costs, and
887 with community care and 50% increase in drug costs.
Under the limited benefit scenario, the ICER of bisoprolol over placebo was:
2,557 with shared care and CIBIS II hospitalisation data,
2,761 with community care and CIBIS II hospitalisation data,
cost-saving with shared care and assumptions on hospitalisation,
69 with community care and assumptions on hospitalisation,
cost-saving with shared care and no discount rate,
cost-saving with community care and no discount rate,
502 with shared care and 20% decrease in inpatient costs,
705 with community care and 20% decrease in inpatient costs,
cost-saving with shared care and 20% increase in inpatient costs,
cost-saving with community care and 20% increase in inpatient costs,
583 with shared care and 50% increase in drug costs, and
786 with community care and 50% increase in drug costs.
Assuming that 850,000 patients could receive bisoprolol in the UK, the economic impact for the NHS over 5 years would be about 8.9 million.