Table a4 Results of one-way sensitivity analysis

From: Cost-effectiveness of sentinel lymph node biopsy vs inguinofemoral lymphadenectomy in women with vulval cancer

Scenario

ICER Overall survival at 2 years

ICER Survival free of morbidity for 2 years

ICER Survival free of long-term morbidity for 2 years

Baseline

IFL

Dominates

  

Blue dye+ultrastaging

 

£2400

£3700

99mTc+ultrastaging

 

£4900

£8900

99mTc+blue dye+ultrastaging

 

£41 200

£74 300

Age=55

IFL

Dominates

  

Blue dye+ultrastaging

 

£2300

£3600

99mTc+ultrastaging

 

£4900

£8800

99mTc+blue dye+ultrastaging

 

£40 900

£73 800

Age=75

IFL

Dominates

  

Blue dye+ultrastaging

 

£2400

£4200

99mTc+ultrastaging

 

£5100

£9000

99mTc+blue dye+ultrastaging

 

£42 600

£76 000

Increased mortality due to patient morbidity

IFL

Dominates

  

Blue dye+ultrastaging

 

£2300

£3700

99mTc+ultrastaging

 

£4900

£8700

99mTc+blue dye+ultrastaging

 

£40 700

£72 000

Cost of implementing 99mTc + blue dye together

Cost of 99mTc + blue dye=cost 99mTc (£3836)

 IFL

Dominates

  

 Blue dye+ultrastaging

 

£2400

£3700

 99mTc+blue dye+ultrastaging

 

£4700

£8400

Cost of 99mTc + blue dye=50% more than the cost of 99mTc (£5754)

IFL

Dominates

  

Blue dye+ultrastaging

 

£2400

£3700

99mTc+ultrastaging

 

£4900

£8900

99mTc+blue dye+ultrastaging

 

£1 95 700

£3 52 600

Groin recurrence rate following negative SLN biopsy result for metastasis =2/31

IFL

Dominates

  

Blue dye+ultrastaging

 

£2600

£4300

99mTc+ultrastaging

 

£5200

£9800

99mTc+blue dye+ultrastaging

 

£42 400

£81 300

=30%

IFL

Dominates

  

Blue dye+H&E

 

£4800

 

Blue dye+ultrastaging

  

£28 400

99mTc+H&E

 

£7500

 

99mTc+ultrastaging

 

£12 000

£41 500

99mTc+blue dye+ultrastaging

 

£54 000

£2 93 400

Monitoring every 3 months for all pathways

IFL

Dominates

  

Blue dye+ultrastaging

 

£600

£900

99mTc+ultrastaging

 

£3500

£6300

99mTc+blue dye+ultrastaging

 

£39 800

£71 700

False positive result=1.2% for all SLN biopsy pathways

IFL

Dominates

  

Blue dye+ultrastaging

 

£2400

£3800

99mTc+ultrastaging

 

£5000

£9000

99mTc+blue dye+ultrastaging

 

£41 700

£75 200

  1. Abbreviations: H&E=haematoxylin and eosin; ICER=incremental cost-effectiveness ratio; IFL=inguinofemoral lymphadenectomy; SLN=sentinel lymph node.