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Health economics — ICER + CE plane

A typed economic evaluation rendered on the cost-effectiveness plane. Typed FlowScript for health economics. Keywords: cost-effectiveness, ICER, QALY, health economics, CEA.

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Cost-effectiveness plane — Telehealth CBT for adult anxiety — base caseCost-effectiveness plane of 4 strategies against Standard of care (clinic GAD-7 + meds). Guided self-help app + coach: USD 1,900, 3.66 QALYs, on the frontier. Standard of care (clinic GAD-7 + meds): USD 4,200, 3.41 QALYs, reference. Telehealth CBT (12 sessions): USD 5,400, 3.78 QALYs, on the frontier, ICER USD 29,167 per QALY against Guided self-help app + coach. In-person CBT, 20 sessions: USD 9,100, 3.81 QALYs, on the frontier, ICER USD 123,333 per QALY against Telehealth CBT (12 sessions).COST-EFFECTIVENESS PLANE · INCREMENTAL ANALYSIS4 STRATEGIES · USD · 5YTelehealth CBT for adult anxiety — base caseIncremental cost and QALYs against Standard of care (clinic GAD-7 + meds) · payer perspective · discounted at 3.5% a year−0.10+0.1+0.2+0.3+0.4+0.5−4,000−2,0000+2,000+4,000+6,000Incremental QALYs vs Standard of care (clinic GAD-7 + meds)Incremental cost (USD)NW · less effective, more costlyNE · more effective, more costlySW · less effective, less costlySE · more effective, less costlyICER USD 29,167 / QALYICER USD 123,333 / QALYGuided self-help app + coach: cost USD 1,900, 3.66 QALYs; on the frontierGuided self-help app + coachTelehealth CBT (12 sessions): cost USD 5,400, 3.78 QALYs; on the frontierTelehealth CBT (12 sessions)In-person CBT, 20 sessions: cost USD 9,100, 3.81 QALYs; on the frontierIn-person CBT, 20 sessionsStandard of care (clinic GAD-7 + meds): cost USD 4,200, 3.41 QALYs; the referenceStandard of care (clinic GAD-7 + meds)ReferenceOn the frontierFrontierINCREMENTAL ANALYSIS · BY COSTGuided self-help app + coachUSD 1,900 · 3.66 QALYs · Δ −USD 2,300, +0.25Frontier baselineStandard of care (clinic GAD-7 + meds) (reference)USD 4,200 · 3.41 QALYsDominatedno ICER — eliminatedTelehealth CBT (12 sessions)USD 5,400 · 3.78 QALYs · Δ +USD 1,200, +0.37ICER USD 29,167 per QALYvs Guided self-help app + coachIn-person CBT, 20 sessionsUSD 9,100 · 3.81 QALYs · Δ +USD 4,900, +0.40ICER USD 123,333 per QALYvs Telehealth CBT (12 sessions)Solid line: the cost-effectiveness frontier. Each ICER is sequential — against the strategy directly below it on the frontier, not against Standard of care (clinic GAD-7 + meds). Fullincremental analysis: strategies ordered by cost, strongly dominated options (×) removed, then extendedly dominated options (◇) removed until the ratios rise.

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econ_model cbt {
  title: "Telehealth CBT for adult anxiety — base case"
  perspective: "payer"
  currency: "USD"
  horizon: "5y"
  discount: 0.035
}

intervention usual_care {
  name: "Standard of care (clinic GAD-7 + meds)"
  cost: 4200
  qalys: 3.41
  arm: "standard-of-care"
}

intervention telehealth_cbt {
  name: "Telehealth CBT (12 sessions)"
  cost: 5400
  qalys: 3.78
  comparator: usual_care
  arm: "treatment"
}

intervention guided_app {
  name: "Guided self-help app + coach"
  cost: 1900
  qalys: 3.66
  comparator: usual_care
  arm: "treatment"
}

intervention high_intensity {
  name: "In-person CBT, 20 sessions"
  cost: 9100
  qalys: 3.81
  comparator: usual_care
  arm: "treatment"
}

view ce: ce_plane