This work package will perform an economic evaluation of the treatments that are evaluated in PRECIOUS. The evaluation will use a long-term and societal perspective, and include both the direct and indirect, monetary and non-monetary costs and health benefits. Cost will be valued in monetary units and health benefit in quality adjusted life years (QALYs).

We will use a Markov model to estimate the monetary costs and the QALYs. In this model each patient is assumed to be in a certain state, and for each time period there is a certain probability that the patient will go from one state to another (“transition probability”). We will simulate the flow of patients between the different states and use this to estimate the average QALYs patients will gain. The incremental costs will be divided by the incremental QALYs, and the incremental cost/benefit ratio is a key variable in the decision to recommend a treatment.