Interventions:
The interventions were well described and represented current practice in the study setting.
Effectiveness/benefits:
The effectiveness data were derived from a wide range of sources. The methods used to review the literature were not reported, which makes it impossible to determine if the best available evidence was used for the model. The authors reported that the best available clinical and effectiveness data from Jamaica were used for the estimates of survival, but it was not clear why these particular estimates were considered the best. The outcome used was the number of life-years saved which, while appropriate, could have been extended to include quality of life.
Costs:
The authors reported that a modified societal perspective was used. However, given the cost categories included (drug and hospital costs), the perspective could have been more accurately described as that of the health care system. Mean costs for inpatient and outpatient visits were reported, along with the expected number of visit. However, drug costs were reported as monthly costs rather than as separate unit costs and quantities. Information on the quantity of inpatient and outpatient visits was not available for the countries under consideration, so US data were used and subjected to extensive sensitivity analysis.
Analysis and results:
The authors conducted an appropriate incremental analysis and full results were presented. The methods used throughout the economic evaluation were well reported, although a list of the variables subjected to sensitivity analysis and the range of values used would have been helpful. The authors acknowledged the main limitations of their analysis.
Concluding remarks:
On the whole, the methodology of the study seemed appropriate and was clearly reported. The authors' conclusions appear appropriate.