Supplement Material
The Cost-effectiveness of Nalmefene for Reduction of Alcohol Consumption in Alcohol-Dependent Patients With High or Very High Drinking-Risk Levels From a United Kingdom Societal Perspective
Journal Name:
CNS Drugs
Authors
Thor-Henrik Brodtkorb, PhD
Melissa Bell, MSc
Adam H Irving, MSc
Philippe Laramée, PhD
Corresponding Author
Thor-Henrik Brodtkorb
RTI Health Solutions
E-mail:
Table Supplement 1.Costs, Utilities, and Resource Use Inputs to the Model for the Base-Case Analysis
Parameter / Values / SourceBase-caseDRL health states / Utility
Short-term DRLs / 0.017a / ESENSE 1, ESENSE 2, SENSE (Gual et al., 2013; Mann et al., 2013; van den Brink et al., 2013; van den Brink et al., 2014)
Long-term high and very high DRL / 0.795 / ESENSE 1, ESENSE 2, SENSE (Gual et al., 2013; Mann et al., 2013; van den Brink et al., 2013; van den Brink et al., 2014)
Long-term medium DRL / 0.825 / ESENSE 1, ESENSE 2, SENSE (Gual et al., 2013; Mann et al., 2013; van den Brink et al., 2013; van den Brink et al., 2014)
Long-term controlled drinking / 0.862 / ESENSE 1, ESENSE 2, SENSE (Gual et al., 2013; Mann et al., 2013; van den Brink et al., 2013; van den Brink et al., 2014)
Treatment / Propor-tion of Visits / Number of Visits in First Month / Number of Subsequent Visits per Month / Cost / Source
Nalmefene, 1 dose / — / — / — / £3.03 / MIMS,2014
Visit to GP, including psychosocial supportb / 75% / 3 / 1 / £63 / PSSRU,2012
First attendance to specialised care, including psychosocial support / 25% / 1 / — / £94 / PSSRU,2012
Follow-up attendance to specialised care, including psychosocial support / — / 2 / 1 / £94 / PSSRU,2012
Alcohol-Attributable Harmful Eventsc / Utility / Source / Cost per Event / Source
Ischaemic heart disease / 0.643 / SAPM(Purshouse et al., 2009) / £2,491 / SAPMd(Purshouse et al., 2009)
Ischaemic stroke / 0.564 / SAPM(Purshouse et al., 2009) / £4,088 / SAPMd(Purshouse et al., 2009)
Haemorrhagic stroke / 0.657 / SAPM(Purshouse et al., 2009) / £5,799 / SAPMd(Purshouse et al., 2009)
Cirrhosis of the liver / 0.494 / SAPM(Purshouse et al., 2009) / £3,750 / SAPMd(Purshouse et al., 2009)
Pancreatitis / 0.447 / SAPM(Purshouse et al., 2009) / £4,373 / SAPMd(Purshouse et al., 2009)
Lower respiratory infections / 0.200e / Sisk et al., 2003 / £2,999f / NHS (2010-2011)
Motor vehicle accidents / 0.598 / SAPM(Purshouse et al., 2009) / £5,468 / SAPMd(Purshouse et al., 2009)
Injuries other than from transport / 0.592g / SAPM(Purshouse et al., 2009) / £5,296 / SAPMd(Purshouse et al., 2009)
DRL = drinking-risk level; GP = general practitioner; ICD-10 = International Classification of Diseases 10th Revision; NHS = National Health Service; NICE=National Institute for Health and Care Excellence; PSSRU = Personal Social Services Research Unit; QALY=quality-adjusted life-year; SAPM = Sheffield Alcohol Policy Model.
aQALY difference between nalmefene plus psychosocial support and psychosocial support alone for the first year of treatment, calculated from the clinical trials (area between the curves). QALYs lost were later applied to each arm for the consideration of alcohol-attributable harmful events. A mixed model repeated measures analysis was carried out using EQ-5D utilities and observed case data from all three trials to estimate treatment effect for the first 6 months. The model used an unstructured covariance matrix and included country, sex, time (months 1-6) and treatment as fixed effects, as well as baseline value-by-time and treatment-by-time interactions.
b An estimate based on a 17.2-minute visit to a GP.
cHospital admission data only took into account the first diagnosis for hospitalisation and not the multiple alcohol-attributable conditions that are often diagnosed and managed during the same hospitalisation.
dBased on the ICD-10 code of event, including the following components associated with one hospital admission: inpatient visits, outpatient visits, accident and emergency visits, ambulance GP consultation, nurse visits, and other health care costs. For events with multiple codes, the weighted average calculated from the proportion of admissions reported in the Hospital Episode Statistics (2010-2011) for England was used.
eThe utility score from Sisk et al. (2003) was during patient hospitalisation. Thus, it was applied to the model for 9 days, which was the weighted average length of hospital stay for lower respiratory infections (NHS, 2010-2011).
fWeighted average using Elective Inpatient Healthcare Resource Groupdata; Currency Code DZ11A, DZ11B, DZ11C, DZ23A, DZ23B, and DZ23C.
gThe utility value used in the model for other injuries was calculated as a weighted average combining the utility scores presented in the SAPM for the subevents included in other injuries (based on ICD-10 codes). These then were matched with the number of admissions reported in Hospital Episode Statistics (2011) for England (ICD-10 data were used for modelling the incidence of alcohol-attributable events)(Purshouse et al., 2009).
Sources: The utilities used in the SAPM were derived from a single source, the Health Outcomes Data Repository, to avoid potential bias and variability between studies. The repository’s data measured utilities using the EQ-5D, as recommended by NICE for health economic evaluations. Data used in the SAPM were collected by the Cardiff and Vale NHS Hospital Trust, serving a local population of 424,000 and providing tertiary care for the whole of Wales. Patients discharged from hospital were requested to complete an EQ-5D questionnaire 6 weeks after discharge. Data were collected on demography, health utility (EQ-5D index), and diagnoses (ICD-10 code). A mean utility value was extracted for each condition based on diagnoses (or ICD-10 codes) and adjusted for age using the percentage of increment or decrement observed for utilities in the general population. The Health Outcomes Data Repository is no longer available online; therefore, the reported values from the SAPM have been used in the model.
Table Supplement 2. Summary of Variables Applied in the Economic Model
Mean Value / Standard Error / Range Tested: OWSA / ICER Range From OWSAGeneral parameters
Discount rate: cost / 3.50% / n/a / 0.00% to 6.00%a / Nalmefene dominates
Discount rate: outcomes / 3.50% / n/a / 0.00% to 6.00%a / Nalmefene dominates
Proportion of day at risk of road traffic accident (hours) / 3 / n/a / 1 to 4a / Nalmefene dominates
Proportion of day at risk of other accidents (hours) / 3 / n/a / 1 to 4a / Nalmefene dominates
Proportion of visits to GP (to specialised care) / 75% / n/a / 0.00% to 100.00%a / Nalmefene dominates
Number of visits, first month, for nalmefene treatment / 3.00 / n/a / 1 to 4a / Nalmefene dominates
Number of visits, first month, for PSS treatment / 3.00 / n/a / 1 to 4a / Nalmefene dominates
Number of visits, first month, for variable treatment / 3.00 / n/a / 1 to 4a / Nalmefene dominates
Medical visits, per month, nalmefene / 1.00 / n/a / 0.5 to 2a / Nalmefene dominates
Medical visits, per month, for PSS treatment / 1.00 / n/a / 0.5 to 2a / Nalmefene dominates
Medical visits, per month, for no treatment / 1.00 / n/a / 0.5 to 2a / Nalmefene dominates
Cost of nalmefene / £3.03 / n/a / £2.42 to £3.64a / Nalmefene dominates
General population probability of harmful event
Male general population probability: heart disease / 0.71% / 0.000713b / 0.57% to 0.85% / Nalmefene dominates
Male general population probability: ischaemic stroke / 0.15% / 0.000146b / 0.12% to 0.18% / Nalmefene dominates
Male general population probability: haemorrhagic stroke / 0.05% / 0.000048b / 0.04% to 0.06% / Nalmefene dominates
Male general population probability: cirrhosis of the liver / 0.06% / 0.000055b / 0.04% to 0.07% / Nalmefene dominates
Male general population probability: pancreatitis / 0.05% / 0.000055b / 0.04% to 0.07% / Nalmefene dominates
Male general population probability: lower respiratory infection / 0.56% / 0.000564b / 0.45% to 0.67% / Nalmefene dominates
Male general population probability: road traffic accident / 0.07% / 0.000067b / 0.05% to 0.08% / Nalmefene dominates
Male general population probability: fall or other injury / 2.33% / 0.002334b / 1.88% to 2.79% / Nalmefene dominates
Female general population probability: heart disease / 0.36% / 0.000356b / 0.29% to 0.43% / Nalmefene dominates
Female general population probability: ischaemic stroke / 0.15% / 0.000147b / 0.12% to 0.18% / Nalmefene dominates
Female general population probability: haemorrhagic stroke / 0.05% / 0.000045b / 0.04% to 0.05% / Nalmefene dominates
Female general population probability: cirrhosis of the liver / 0.03% / 0.000031b / 0.02% to 0.04% / Nalmefene dominates
Female general population probability: pancreatitis / 0.04% / 0.000039b / 0.03% to 0.05% / Nalmefene dominates
Female general population probability: lower respiratory infection / 0.52% / 0.000518b / 0.42% to 0.62% / Nalmefene dominates
Female general population probability: road traffic accident / 0.03% / 0.000029b / 0.02% to 0.03% / Nalmefene dominates
Female general population probability: fall or other injury / 2.29% / 0.002295b / 1.85% to 2.74% / Nalmefene dominates
Mortality, male general population probability: heart disease / 0.14% / 0.000144b / 0.12% to 0.17% / Nalmefene dominates
Mortality, male general population probability: ischaemic stroke / 0.03% / 0.00003b / 0.02% to 0.04% / Nalmefene dominates
Mortality, male general population probability: haemorrhagic stroke / 0.01% / 0.000014b / 0.01% to 0.02% / Nalmefene dominates
Mortality, male general population probability: cirrhosis of the liver / 0.02% / 0.000016b / 0.01% to 0.02% / Nalmefene dominates
Mortality, male general population probability: pancreatitis / 0.00% / 0.000002b / 0.00% to 0.00% / Nalmefene dominates
Mortality, male general population probability: lower respiratory infection / 0.04% / 0.000044b / 0.04% to 0.05% / Nalmefene dominates
Mortality, male general population probability: road traffic accident / 0.00% / 0.000003b / 0.00% to 0.00% / Nalmefene dominates
Mortality, male general population probability: fall or other injury / 0.03% / 0.000035b / 0.03% to 0.04% / Nalmefene dominates
Mortality, female general population probability: heart disease / 0.10% / 0.000099b / 0.08% to 0.12% / Nalmefene dominates
Mortality, female general population probability: ischaemic stroke / 0.05% / 0.000047b / 0.04% to 0.06% / Nalmefene dominates
Mortality, female general population probability: haemorrhagic stroke / 0.02% / 0.000017b / 0.01% to 0.02% / Nalmefene dominates
Mortality, female general population probability: cirrhosis of the liver / 0.01% / 0.000009b / 0.01% to 0.01% / Nalmefene dominates
Mortality, female general population probability: pancreatitis / 0.00% / 0.000002b / 0.00% to 0.00% / Nalmefene dominates
Mortality, female general population probability: lower respiratory infection / 0.06% / 0.000058b / 0.05% to 0.07% / Nalmefene dominates
Mortality, female general population probability: road traffic accident / 0.00% / 0.000001b / 0.00% to 0.00% / Nalmefene dominates
Mortality, female general population probability: fall or other injury / 0.02% / 0.000022b / 0.02% to 0.03% / Nalmefene dominates
Average consumption (g/day) per drinkingrisk level
Males
Very high risk / 134 / 1.523 / 130.6 to 136.6 / Nalmefene dominates
High risk / 78 / 0.411 / 76.9 to 78.5 / Nalmefene dominates
Medium risk / 50 / 0.235 / 49.3 to 50.2 / Nalmefene dominates
Low risk / 21 / 0.331 / 20.1 to 21.4 / Nalmefene dominates
Females
Very high risk / 94 / 1.974 / 90.3 to 98.1 / Nalmefene dominates
High risk / 50 / 0.387 / 48.9 to 50.4 / Nalmefene dominates
Medium risk / 29 / 0.278 / 28.9 to 30.0 / Nalmefene dominates
Low risk / 11 / 0.301 / 10.6 to 11.8 / Nalmefene dominates
Consumption (g/day) per HDD
Males
Very high risk / 153 / 2.302 / 148.2 to 157.2 / Nalmefene dominates
High risk / 113 / 1.500 / 109.9 to 115.7 / Nalmefene dominates
Medium risk / 107 / 1.845 / 103.2 to 110.5 / Nalmefene dominates
Low risk / 81 / 1.673 / 77.8 to 84.3 / Nalmefene dominates
Females
Very high risk / 108 / 2.369 / 103.8 to 113.1 / Nalmefene dominates
High risk / 74 / 1.406 / 70.8 to 76.3 / Nalmefene dominates
Medium risk / 67 / 1.253 / 64.5 to 69.4 / Nalmefene dominates
Low risk / 50 / 1.864 / 45.9 to 53.2 / Nalmefene dominates
Number of HDDs per month per drinkingrisk level
Males
Very high risk / 25 / 0.193 / 24.6 to 25.4 / Nalmefene dominates
High risk / 19 / 0.211 / 18.6 to 19.4 / Nalmefene dominates
Medium risk / 10 / 0.137 / 9.7 to 10.2 / Nalmefene dominates
Low risk / 3 / 0.085 / 3.2 to 3.5 / Nalmefene dominates
Females
Very high risk / 24 / 0.207 / 24.0 to 24.8 / Nalmefene dominates
High risk / 19 / 0.344 / 17.9 to 19.2 / Nalmefene dominates
Medium risk / 9 / 0.208 / 8.7 to 9.6 / Nalmefene dominates
Low risk / 3 / 0.126 / 2.5 to 3 / Nalmefene dominates
Nalmefene intake per month
Males
Very high risk / 20 / 0.637 / 19.2 to 21.7 / Nalmefene dominates
High risk / 20 / 0.433 / 19.0 to 20.7 / Nalmefene dominates
Medium risk / 17 / 0.444 / 15.7 to 17.4 / Nalmefene dominates
Low risk / 14 / 0.321 / 13.3 to 14.6 / Nalmefene dominates
Abstinence / 9 / 0.972 / 6.9 to 10.7 / Nalmefene dominates
Females
Very high risk / 19 / 0.830 / 17.5 to 20.7 / Nalmefene dominates
High risk / 19 / 0.765 / 17.4 to 20.4 / Nalmefene dominates
Medium risk / 16 / 0.630 / 15.2 to 17.7 / Nalmefene dominates
Low risk / 15 / 0.631 / 13.6 to 16.1 / Nalmefene dominates
Abstinence / 8 / 1.497 / 4.8 to 10.6 / Nalmefene dominates
Cost parameters
Cost of visit to GP / £63 / 13c / £38 to £88 / Nalmefene dominates
Cost of first attendance to specialised care / £94 / 19c / £57 to £131 / Nalmefene dominates
Cost of follow-up attendance to specialised care / £94 / 19c / £57 to £131 / Nalmefene dominates
Cost of heart disease / £2,491 / 498c / £1,515 to £3,468 / Nalmefene dominates
Cost of ischaemic stroke / £4,088 / 818c / £2,486 to £5,691 / Nalmefene dominates
Cost of haemorrhagic stroke / £5,799 / 1160c / £3,526 to £8,072 / Nalmefene dominates
Cost of cirrhosis of the liver / £3,750 / 750c / £2,280 to £5,220 / Nalmefene dominates
Cost of pancreatitis / £4,373 / 875c / £2,659 to £6,087 / Nalmefene dominates
Cost of lower respiratory infection / £2,999 / 600c / £1,824 to £4,175 / Nalmefene dominates
Cost of transport injury / £5,468 / 1094c / £3,325 to £7,612 / Nalmefene dominates
Cost of other injury / £5,296 / 1059c / £3,220 to £7,372 / Nalmefene dominates
Utility parameters
Utility per DRL from ESENSE and SENSE
Very high and high risk / 0.79 / 0.010 / 0.77 to 0.81 / Nalmefene dominates
Medium risk / 0.82 / 0.010 / 0.80 to 0.84 / Nalmefene dominates
Low risk and abstinence / 0.86 / 0.010 / 0.84 to 0.88 / Nalmefene dominates
Utility from area under the curve
Area under the curve from ESENSE and SENSE nalmefene / 0.83 / Composite of the 5 parameters below / 0.81 to 0.86 / Nalmefene dominates
Baseline / 0.79 / 0.015 / n/a / n/a
12 weeks / 0.82 / 0.012 / n/a / n/a
24 weeks / 0.83 / 0.012 / n/a / n/a
36 weeks / 0.84 / 0.019 / n/a / n/a
52 weeks / 0.87 / 0.016 / n/a / n/a
Area under the curve from ESENSE and SENSE MBI / 0.81 / Composite of the 5 parameters below / 0.78 to 0.85 / Nalmefene dominates
Baseline / 0.79 / 0.016 / n/a / n/a
12 weeks / 0.80 / 0.013 / n/a / n/a
24 weeks / 0.81 / 0.014 / n/a / n/a
36 weeks / 0.83 / 0.031 / n/a / n/a
52 weeks / 0.84 / 0.026 / n/a / n/a
Utility of harmful events
Utility: general population (used for adjustment) / 0.85 / 0.026 / 0.80 to 0.90 / Nalmefene dominates
Utility: heart disease / 0.64 / 0.020 / 0.60 to 0.68 / Nalmefene dominates
Utility: ischaemic stroke / 0.56 / 0.020 / 0.52 to 0.60 / Nalmefene dominates
Utility:haemorrhagic stroke / 0.66 / 0.020 / 0.62 to 0.70 / Nalmefene dominates
Utility: cirrhosis of the liver / 0.49 / 0.020 / 0.45 to 0.53 / Nalmefene dominates
Utility: pancreatitis / 0.45 / 0.020 / 0.41 to 0.49 / Nalmefene dominates
Utility: lower respiratory tract infections / 0.20 / 0.020 / 0.16 to 0.24 / Nalmefene dominates
Utility: transport injuries / 0.60 / 0.020 / 0.56 to 0.64 / Nalmefene dominates
Utility: injuries other than transport / 0.59 / 0.020 / 0.55 to 0.63 / Nalmefene dominates
Parameters for relative risk of harmful events
Male RR: ischaemic heart disease / 0.98 / 0.269 / 0.45 to 1.51 / Nalmefene dominates
Male RR: ischaemic stroke / 0.98 / 0.269 / 0.45 to 1.51 / Nalmefene dominates
Male RR: haemorrhagic stroke / 0.77 / 0.157 / 0.46 to 1.08 / Nalmefene dominates
Male RR: cirrhosis of the liver / Composite of the 2 parameters below / Nalmefene dominates
Beta 1 / 1.69 / 0.190 / 1.32 to 2.06
Beta 2 / 1.11 / 0.268 / 0.58 to 1.63
Male RR: pancreatitis / 1.50 / 0.171 / 1.16 to 1.83 / Nalmefene dominates
Male RR: lower respiratory infection / 0.48 / 0.192 / 0.10 to 0.85 / Nalmefene dominates
Male RR: transport injury / Composite of the 3 parameters below / Nalmefene dominates
Beta 1 / 9.12 / 0.912b / 7.33 to 10.9 / n/a
Beta 2 / 3.29 / 0.329b / 2.65 to 3.94 / n/a
Beta 3 / 0.21 / 0.021b / 0.17 to 0.25 / n/a
Male RR: other injury / 2.19 / 0.250 / 1.70 to 2.68 / Nalmefene dominates
Female RR: ischaemic heart disease / 0.98 / 0.269 / 0.45 to 1.51 / Nalmefene dominates
Female RR: ischaemic stroke / 0.98 / 0.269 / 0.45 to 1.51 / Nalmefene dominates
Female RR:haemorrhagic stroke / Composite of the 2 parameters below / Nalmefene dominates
Beta 1 / 0.94 / 0.257 / 0.44 to 1.44
Beta 2 / 0.94 / 0.176 / 0.60 to 1.29
Female RR: cirrhosis of the liver / Composite of the 2 parameters below / Nalmefene dominates
Beta 1 / 2.35 / 0.224 / 1.91 to 2.79
Beta 2 / 0.90 / 0.320 / 0.27 to 1.53
Female RR: pancreatitis / 1.50 / 0.171 / 1.16 to 1.83 / Nalmefene dominates
Female RR: lower respiratory infection / 0.48 / 0.192 / 0.10 to 0.85 / Nalmefene dominates
Female RR:transport injury / Composite of the 3 parameters below / Nalmefene dominates
Beta 1 / 70.20 / 7.02b / 56.44 to 83.95 / n/a
Beta 2 / 3.29 / 0.329b / 2.65 to 3.94 / n/a
Beta 3 / 1.61 / 0.161b / 1.29 to 1.92 / n/a
Female RR: other injury / 2.19 / 0.250 / 1.70 to 2.68 / Nalmefene dominates
Male RR mortality: haemorrhagic stroke / 0.69 / 0.114 / 0.47 to 0.91 / Nalmefene dominates
Male RR mortality: cirrhosis of the liver / 1.69 / 0.190 / 1.32 to 2.06 / Nalmefene dominated
Female RR mortality: haemorrhagic stroke / 1.47 / 0.354 / 0.77 to 2.16 / Nalmefene dominates
Female RR mortality: cirrhosis of the liver / 2.35 / 0.224 / 1.91 to 2.79 / Nalmefene dominates
Probability of relapse / 0.19 / 0.047 / 0.1 to 0.28 / Nalmefene dominates
Parameters for secondary abstinence treatment
Cost of assisted withdrawal / £1,044 / 209c / 634.75 to 1453.25 / Nalmefene dominates
Cost of relapse prevention programme / £1,172 / 234c / 712.58 to 1631.42 / Nalmefene dominates
Cost of relapse prevention programme, subsequent years / £1,172 / 234c / 712.58 to 1631.42 / Nalmefene dominates
Secondary treatment effect / 81.8% / 0.156 / 0.51 to 1.12 / Nalmefene dominates
Proportion having new treatment following relapse / 50.0% / 0.05b / 0.40 to 0.60 / Nalmefene dominates
Proportion drinking heavily or very heavily and having new treatment / 50.0% / 0.05b / 0.40 to 0.60 / Nalmefene dominates
Parameters for societal perspective / Nalmefene dominates
Male:causing death by dangerous driving rate / 0.00001 / 0.000003c / 0.000008 to 0.000019 / Nalmefene dominates
Male: causing death by dangerous driving slope parameter / 0.02928 / 0.005856c / 0.017804 to 0.040761 / Nalmefene dominates
Male: more serious wounding rate / 0.00089 / 0.000178c / 0.000540 to 0.001237 / Nalmefene dominates
Male: more serious wounding slope parameter / 0.02047 / 0.004093c / 0.012443 to 0.028489 / Nalmefene dominates
Male: less serious wounding rate / 0.10720 / 0.021440c / 0.065177 to 0.149221 / Nalmefene dominates
Male: less serious wounding slope parameter / 0.02047 / 0.004093c / 0.012443 to 0.028489 / Nalmefene dominates
Male: assault on a constable rate / 0.00478 / 0.000957c / 0.002908 to 0.006658 / Nalmefene dominates
Male: assault on a constable slope parameter / 0.03638 / 0.007275c / 0.022117 to 0.050636 / Nalmefene dominates
Male: assault without injury rate / 0.04554 / 0.009107c / 0.027686 to 0.063387 / Nalmefene dominates
Male: assault without injury slope parameter / 0.03638 / 0.007275c / 0.022117 to 0.050636 / Nalmefene dominates
Male: criminal damage rate / 0.13088 / 0.026175c / 0.079573 to 0.182180 / Nalmefene dominates
Male: criminal damage slope parameter / 0.07469 / 0.014938c / 0.045411 to 0.103967 / Nalmefene dominates
Male: theft from a person rate / 0.01292 / 0.002583c / 0.007853 to 0.017980 / Nalmefene dominates
Male: theft from a person slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: robbery rate / 0.01016 / 0.002033c / 0.006179 to 0.014147 / Nalmefene dominates
Male: robbery slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: robbery (business) rate / 0.00095 / 0.000190c / 0.000576 to 0.001319 / Nalmefene dominates
Male: robbery (business) slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: burglary in a dwelling rate / 0.01914 / 0.003829c / 0.011640 to 0.026649 / Nalmefene dominates
Male: burglary in a dwelling slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: burglary not in a dwelling rate / 0.02062 / 0.004123c / 0.012535 to 0.028699 / Nalmefene dominates
Male: burglary not in a dwelling slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: theft of a pedal cycle rate / 0.00973 / 0.001945c / 0.005914 to 0.013540 / Nalmefene dominates
Male: theft of a pedal cycle slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: theft from vehicle rate / 0.03441 / 0.006881c / 0.020919 to 0.047893 / Nalmefene dominates
Male: theft from vehicle slope parameter / 0.00860 / 0.001720c / 0.005229 to 0.011971 / Nalmefene dominates
Male: aggravated vehicle taking rate / 0.00032 / 0.000064c / 0.000195 to 0.000446 / Nalmefene dominates
Male: aggravated vehicle taking slope parameter / 0.00860 / 0.001720c / 0.005229 to 0.011971 / Nalmefene dominates
Male: theft of vehicle rate / 0.00535 / 0.001071c / 0.003255 to 0.007452 / Nalmefene dominates
Male: theft of vehicle slope parameter / 0.00860 / 0.001720c / 0.005229 to 0.011971 / Nalmefene dominates
Male: other theft rate / 0.03543 / 0.007086c / 0.021540 to 0.049315 / Nalmefene dominates
Male: other theft slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: theft from shops rate / 0.84053 / 0.168107c / 0.511044 to 1.170022 / Nalmefene dominates
Male: theft from shops slope parameter / 0.00168 / 0.000336c / 0.001021 to 0.002338 / Nalmefene dominates
Male: violent disorder rate / 0.00009 / 0.000018c / 0.000056 to 0.000128 / Nalmefene dominates
Male: violent disorder slope parameter / 0.02928 / 0.005856c / 0.017804 to 0.040761 / Nalmefene dominates
Male: sexual offences rate / 0.01049 / 0.002097c / 0.006375 to 0.014596 / Nalmefene dominates
Male: sexual offences slope parameter / 0.02928 / 0.005856c / 0.017804 to 0.040761 / Nalmefene dominates
Male: homicide rate / 0.00004 / 0.000008c / 0.000025 to 0.000056 / Nalmefene dominates
Male: homicide slope parameter / 0.02928 / 0.005856c / 0.017804 to 0.040761 / Nalmefene dominates
Female: causing death by dangerous driving rate / 0.000003 / 0.000001c / 0.000002 to 0.000004 / Nalmefene dominates
Female: causing death by dangerous driving slope parameter / 0.06583 / 0.013167c / 0.040027 to 0.091640 / Nalmefene dominates
Female: more serious wounding rate / 0.00014 / 0.000029c / 0.000088 to 0.000201 / Nalmefene dominates
Female: more serious wounding slope parameter / 0.09664 / 0.019329c / 0.058759 to 0.134527 / Nalmefene dominates
Female: less serious wounding rate / 0.01747 / 0.003493c / 0.010620 to 0.024314 / Nalmefene dominates
Female: less serious wounding slope parameter / 0.09664 / 0.019329c / 0.058759 to 0.134527 / Nalmefene dominates
Female: assault on a constable rate / 0.00078 / 0.000156c / 0.000474 to 0.001085 / Nalmefene dominates
Female: assault on a constable slope parameter / 0.04369 / 0.008737c / 0.026561 to 0.060811 / Nalmefene dominates
Female: assault without injury rate / 0.00742 / 0.001484c / 0.004511 to 0.010328 / Nalmefene dominates
Female: assault without injury slope parameter / 0.04369 / 0.008737c / 0.026561 to 0.060811 / Nalmefene dominates
Female: criminal damage rate / 0.01325 / 0.002649c / 0.008053 to 0.018438 / Nalmefene dominates
Female: criminal damage slope parameter / 0.12785 / 0.025569c / 0.077731 to 0.177963 / Nalmefene dominates
Female: theft from a person rate / 0.00437 / 0.000874c / 0.002657 to 0.006082 / Nalmefene dominates
Female: theft from a person slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: robbery rate / 0.00053 / 0.000105c / 0.000321 to 0.000734 / Nalmefene dominates
Female: robbery slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: robbery (business) rate / 0.00005 / 0.000010c / 0.000030 to 0.000069 / Nalmefene dominates
Female: robbery (business) slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: burglary in a dwelling rate / 0.00104 / 0.000207c / 0.000630 to 0.001442 / Nalmefene dominates
Female: burglary in a dwelling slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: burglary not in a dwelling rate / 0.00112 / 0.000223c / 0.000678 to 0.001553 / Nalmefene dominates
Female: burglary not in a dwelling slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: theft of a pedal cycle rate / 0.00329 / 0.000658c / 0.002001 to 0.004581 / Nalmefene dominates
Female: theft of a pedal cycle slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: theft from vehicle rate / 0.01164 / 0.002328c / 0.007077 to 0.016202 / Nalmefene dominates
Female: theft from vehicle slope parameter / 0.25754 / 0.051509c / 0.156587 to 0.358502 / Nalmefene dominates
Female: aggravated vehicle taking rate / 0.00011 / 0.000022c / 0.000066 to 0.000151 / Nalmefene dominates
Female: aggravated vehicle taking slope parameter / 0.25754 / 0.051509c / 0.156587 to 0.358502 / Nalmefene dominates
Female: theft of vehicle rate / 0.00181 / 0.000362c / 0.001101 to 0.002521 / Nalmefene dominates
Female: theft of vehicle slope parameter / 0.25754 / 0.051509c / 0.156587 to 0.358502 / Nalmefene dominates
Female: other theft rate / 0.01199 / 0.002397c / 0.007287 to 0.016683 / Nalmefene dominates
Female: other theft slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: theft from shops rate / 0.13696 / 0.027392c / 0.083271 to 0.190646 / Nalmefene dominates
Female: theft from shops slope parameter / 0.00272 / 0.000544c / 0.001653 to 0.003784 / Nalmefene dominates
Female: violent disorder rate / 0.00001 / 0.000003c / 0.000008 to 0.000018 / Nalmefene dominates
Female: violent disorder slope parameter / 0.06583 / 0.013167c / 0.040027 to 0.091640 / Nalmefene dominates
Female: sexual offences rate / 0.00000 / 0.000000c / 0.000000 to 0.000000 / Nalmefene dominates
Female: sexual offences slope parameter / 0.06583 / 0.013167c / 0.040027 to 0.091640 / Nalmefene dominates
Female: homicide rate / 0.00001 / 0.000001c / 0.000004 to 0.000009 / Nalmefene dominates
Female: homicide slope parameter / 0.06583 / 0.013167c / 0.040027 to 0.091640 / Nalmefene dominates
Cost of causing death by dangerous driving / £1,855,780 / 371156c / £1,128,314 to £2,583,246 / Nalmefene dominates
Cost of more serious wounding / £27,248 / 5450c / £16,567 to £37,930 / Nalmefene dominates
Cost of less serious wounding / £10,247 / 2049c / £6,230 to £14,264 / Nalmefene dominates
Cost of assault on a constable / £1,832 / 366c / £1,114 to £2,550 / Nalmefene dominates
Cost of assault without injury / £1,832 / 366c / £1,114 to £2,550 / Nalmefene dominates
Cost of criminal damage / £1,102 / 220c / £670 to £1,533 / Nalmefene dominates
Cost of theft from a person / £1,074 / 215c / £653 to £1,494 / Nalmefene dominates
Cost of robbery / £9,263 / 1853c / £5,632 to £12,893 / Nalmefene dominates
Cost of robbery (business) / £6,663 / 1333c / £4,051 to £9,275 / Nalmefene dominates
Cost of burglary in a dwelling / £4,157 / 831c / £2,527 to £5,786 / Nalmefene dominates
Cost of burglary not in a dwelling / £3,598 / 720c / £2,188 to £5,008 / Nalmefene dominates
Cost of theft of a pedal cycle / £806 / 161c / £490 to £1,123 / Nalmefene dominates
Cost of theft from vehicle / £1,091 / 218c / £664 to £1,519 / Nalmefene dominates
Cost of aggravated vehicle taking / £5,263 / 1053c / £3,200 to £7,327 / Nalmefene dominates
Cost of theft of vehicle / £5,263 / 1053c / £3,200 to £7,327 / Nalmefene dominates
Cost of other theft / £806 / 161c / £490 to £1,123 / Nalmefene dominates
Cost of theft from shops / £133 / 27c / £81 to £185 / Nalmefene dominates
Cost of violent disorder / £13,237 / 2647c / £8,048 to £18,427 / Nalmefene dominates
Cost of sexual offences / £39,988 / 7998c / £24,313 to £55,664 / Nalmefene dominates
Cost of homicide / £1,855,780 / 371156c / £1,128,314 to £2,583,246 / Nalmefene dominates
Male participation rate / 0.65 / 0.129 / 0.39 to 0.90 / Nalmefene dominates
Male unemployment rate / 0.08 / 0.017 / 0.05 to 0.12 / Nalmefene dominates
Male unemployment slope parameter / 0.08 / 0.016 / 0.05 to 0.11 / Nalmefene dominates
Male absenteeism rate / 0.02 / 0.003 / 0.01 to 0.02 / Nalmefene dominates
Male absenteeism slope parameter / 0.01 / 0.003 / 0.01 to 0.02 / Nalmefene dominates
Female participation rate / 0.53 / 0.106 / 0.32 to 0.74 / Nalmefene dominates
Female unemployment rate / 0.08 / 0.015 / 0.05 to 0.10 / Nalmefene dominates
Female unemployment slope parameter / 0.10 / 0.021 / 0.06 to 0.14 / Nalmefene dominates
Female absenteeism rate / 0.03 / 0.005 / 0.02 to 0.04 / Nalmefene dominates
Female absenteeism slope parameter / 0.01 / 0.001 / 0.00 to 0.01 / Nalmefene dominates
Cost of unemployment and absenteeism: male / £26,756 / 5,351 / £16,268 to £37,244 / Nalmefene dominates
Cost of unemployment and absenteeism: female / £20,104 / 4,021 / £12,223 to £27,985 / Nalmefene dominates
DRL=drinking-risk level; GP=general practitioner; HDD=heavy drinking day; ICER=incremental cost-effectiveness ratio; n/a=not applicable; MBI=motivational brief intervention; OWSA=one-way sensitivity analysis; PSA=probabilistic sensitivity analysis; PSS=psychosocial support; RR=relative risk.