Jeroen van de Pol

96 Chapter 4 Effects Effects on primary outcomes are presented in Table 3 and extensively described in another paper [32]. Mean QALYs measured with EQ-5D per 6 months were 0.369 (0.355–0.377) and 0.367 (0.345–0.370) for respectively the control group and intervention group, resulting in an incremental QALY of − 0.00217. Mean QALYs measured with EQ-VAS over 6 months were 0.345 (0.332–0.356) for the control group and 0.348 (0.335–0.362) for the intervention group, resulting in an incremental QALY of 0.003 Effectiveness measured as reduced health-related complaints with impact over 6 months was − 0.04 complaints in the control group compared to − 0.38 complaints per patient in the intervention group, resulting in an incremental effect of − 0.34 complaints in the intervention group compared to the control group. Unadjusted scores for primary outcomes at baseline and at 3 and 6 months are presented in Supplementary Table 1. Costs Table 3 summarizes the different costs over the 6-month study period. The total mean healthcare costs per patient were €3,809 ± 6,678 in the intervention group compared to €4,189 ± 6,596 in the control group, resulting in incremental healthcare costs of − €380. Mean costs for all different cost categories at each time point for both groups are shown in Supplementary Table 2. Combining the average time spent on a CMR and the updated 2017 hourly rates, the average costs of this CMR per patient would range between €145 and €203 for the community pharmacist, €6 and €8 for the pharmacy technician and €20 and €22 for the consultation with the GP [30,31], which results in a mean intervention cost of €199 ± 67 for a CMR per patient. When adding the intervention costs to the total costs, the total mean costs per patient in the intervention group were €4,008 ± 6,678 compared to €4,189 ± 6,596 in the control group. This results in an incremental cost of − €181 for the intervention compared to usual care. Cost-utility analysis To estimate the ICERs, we used the incremental costs and incremental effects (see Table 3). When HR-QoL measured with EQ-5D is the measure of effect, a loss of QALYs ( − 0.00217) is offset against cost savings ( − €181) resulting in an ICER of €86,360. This can be interpreted as the compensation received in costs for a lost QALY. The CMR dominated usual care for the cost/utility analysis determined with EQ-VAS and cost/change in complaint with impact analysis, being both less costly and more effective.