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Table 2 Average per-patient lifetime discounted costs and quality-adjusted life-years, by diagnostic outcome and strategy

From: Cost-effectiveness of cerebrospinal biomarkers for the diagnosis of Alzheimer’s disease

  Cost (U.S.$) LYs QALYs Probability of each outcome
Lifetime discounted costs and benefits by diagnostic outcome
 AD
  True-positive $298,632 6.781 2.916 8.9%
  False-negative $308,586 6.555 2.660 3.8%
 Not AD
  False-positive $294,732 9.157 5.048 5.2%
  True-negative $283,387 9.157 5.048 82.1%
Lifetime discounted costs and benefits by diagnostic strategy
  Do nothing $286,587 (244,438 to 337,270)   4.745 (3.88 to 5.42)  
  Biomarker analysis (BM) $286,752 (244,044 to 337,163)   4.760 (3.89 to 5.44)  
  Incremental (BM vs. do nothing) $165 (−1865 to 1625)   0.015 (−0.011 to 0.051)  
Incremental cost-effectiveness ratio ($ per QALY gained) $11,032a  
  1. Abbreviations: AD Alzheimer’s disease, LY Life-year, QALY Quality-adjusted life-year
  2. aThe empiric distribution of incremental cost-effectiveness ratios (ICERs) over the 10,000 simulations identified a 40% probability that biomarker analysis (BM) will decrease costs and increase QALYs and a 7% probability that BM will increase costs and decrease QALYs, assuming an average AD prevalence of 12.7%. Therefore, the 95% CI over the ICER ranges from BM is cost-saving to BM is dominated. Empiric 95% CIs were estimated from 10,000 simulations in which all input parameters were varied simultaneously