Interventions:
The interventions were described and were appropriately compared with the usual practice in the authors' setting.
Effectiveness/benefits:
The effectiveness data were from published studies, but the methods used to identify them were not reported, making it unclear if all the best available evidence was used. The designs of the source studies were not stated, which limits the possibility of assessing the validity of the clinical evidence. QALYs were an appropriate outcome measure, as they capture the impact of the intervention on quality of life. Little information on how they were calculated was provided.
Costs:
The cost analysis included only the drug costs, which might have been appropriate for the third-party perspective, if all other costs were assumed to be the same for each dose. The source of the unit cost data was reported and appears to have been appropriate for the authors' setting. Adjustments, including the price year and discounting, were reported.
Analysis and results:
The authors completed an appropriate incremental analysis and the full results were presented. One-way and probabilistic sensitivity analyses were performed on the main uncertain model parameters. The authors noted some limitations to their study, including the possible lack of generalisability to other settings, given the use of Veterans Affairs pharmacy cost data.
Concluding remarks:
There were some limitations in the reporting of the methods, particularly for the effectiveness data. Given the scope of the study, the authors’ conclusions appear to be appropriate.