Table 4: Incremental Costs and Benefits
CMAI |
Average |
Total |
Incremental |
Cost per |
Cost per PCC | |
UC |
+8.4(+7.4) |
Î6A |
NA |
NA |
NA |
N/A |
PCC |
-5.8(-10.3) |
19.8- |
281(350) |
2,250 |
$8.01 ($6.43) |
N/A |
DCM |
-1.0(-2.4) |
21.8 |
205(214) |
10,034 |
$48.95 ($46.89) |
-$102.42 (- $57.24) |
N/A = not applicable
The results indicate that the DCM intervention is subject to what is referred to in the
economic evaluation literature as “dominance”. That is, relative to PCC, it averts
fewer negative behaviours and is more costly. This remains the case whether the post-
intervention or follow-up CMAI scores are used. A less effective and more costly
intervention is not recommended on efficiency grounds. Therefore, DCM is excluded
from the incremental component of the economic evaluation. The cost per negative
behaviour averted in the PCC group relative to UC was $8.01 (post-intervention) and
$6.43 (at follow-up).
This result remained robust under sensitivity analysis. Under all ranges of model
values, DCM remained subject to dominance. The cost per behaviour averted for the
PCC group relative to UC ranged from $6.23 to $9.79 post-intervention, and from
$5.00 to $7.86 at follow-up, suggesting that different organisational contexts will
produce different results. However, the differences in the ICER do not suggest DCM
to be the cost-effective option under any of the circumstances considered here.
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