Interventions:
The chosen interventions were appropriate as they represented the current practice in the authors' setting. Details of the interventions, including their dosage and duration, were reported.
Effectiveness/benefits:
The effectiveness estimates were derived from published studies and the systematic review of the literature should have ensured that the most recent and relevant estimates were included. The use meta-analyses and randomised controlled trials, where possible, should also have ensured the validity of these estimates, but the inclusion criteria were not stated. The authors did not describe how the clinical data were adapted to determine the relevant probabilities for the model. The effectiveness estimates were well reported, with details of the ranges used in the sensitivity analysis. The primary measures of benefit (LYs and QALYs) were appropriate, but little detail was given on the method used to derive the utility weights for the QALYs.
Costs:
The authors did not report the study perspective, so it is not clear if the appropriate cost categories were included. The sources of the resource use and unit costs were reported, but it is not clear that the resource use estimates were appropriate as they were based on the proceedings of a workshop. In some instances, the costs and quantities were reported separately increasing the generalisability of the study to other settings. In other instances, the aggregated costs were reported, which may reduce the generalisability of the results. Adjustments, including the price year and discount rate, were reported.
Analysis and results:
The authors conducted an appropriate incremental analysis comparing terlipressin and octreotide with each other and with placebo and the full results were presented. The results of the sensitivity analyses were discussed and in some instances displayed graphically. The authors acknowledged some minor limitations to their analysis.
Concluding remarks:
The validity of the source for the resource use data was uncertain and the authors' conclusions should be considered with caution.