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Table 3 Cost-effectiveness analysis results comparing deemed to expressed consent in deceased donor KT

From: An ex-ante cost-utility analysis of the deemed consent legislation compared to expressed consent for kidney transplantations in Nova Scotia

Strategy

Expected Cost (95% CI)

Expected QALYs (95% CI)

∆C

∆QALYs

ICUR ($/QALY)

1% increase in deceased donor KT evaluated over a lifetime

 Deemed consent

$308,516

($177,627 to $555,362)

3.86

(2.92 to 4.55)

$349

0.01

32,629

(95% CI:  − 64,279 to 232,488)

Probability of cost-effectiveness if WTP is 61,466: 81%

 Expressed consent

$308,167

($177,663 to $553,897)

3.85

(2.92 to 4.54)

1% increase in deceased donor KT evaluated over five years

 Deemed consent

$192,453

($113,063 to $336,939)

2.16

(1.72 to 2.48)

 − $319

0.01

Expressed consent dominated

 Expressed consent

$192,772

($113,367 to 336,276)

2.15

(1.72 to 2.48)

26% increase in deceased donor KT evaluated over a lifetime

 Deemed consent

$319,824

($177,541 to $608,737)

4.15

(3.06 to 4.92)

$11,657

0.30

38,594

(95% CI: − 41,022 to 220,930)

Probability of cost-effectiveness if WTP is 61,466: 80%

 Expressed consent

$308,167

($177,663 to $553,897)

3.85

(2.92 to 4.54)

26% increase in deceased donor KT evaluated over 5 years

 Deemed consent

$185,057

($108,603 to $331,539)

2.20

(1.69 to 2.56)

 − $7,715

0.05

Expressed consent dominated

 Expressed consent

$192,772

($116,974 to 324,983)

2.15

(1.69 to 2.50)

  1. QALYs quality-adjusted life years, ∆C incremental cost, ∆QALYs incremental QALYs, KT kidney transplantation, QALYs quality-adjusted life years, ICUR incremental cost-utility ratio.
  2. 95% CI from probabilistic sensitivity analysis