Reducing Periconceptional Methylmercury Exposure: Cost–Utility Analysis for a Proposed Screening Program for Women Planning a Pregnancy in Ontario, Canada

http://dx.doi.org/10.1289/ehp.1409034



Table 3. Sensitivity analysis.
Analysis Estimated incremental cost per QALY (Can$)
Abbreviations: Hg(B), blood mercury concentration; HUI3, Health Utilities Index Mark 3; ICUR, incremental cost-utility index (i.e., incremental cost per QALY); INB, incremental net benefit; MMR, mild mental retardation (IQ between 50 and 70); QALY, quality-adjusted life year. The HUI3 disutility for MMR represents the loss in utility associated with having mild mental retardation assessed using the HUI3 questionnaire.
Univariate sensitivity analysis scenario
Base case $18,051
Discount rate of 3% $11,859
Discount rate of 0% $4,453
Variable discount rate $10,119
HUI3 disutility for MMR of –0.56 $12,249
HUI3 disutility for MMR of –0.76 $9,026
Precision of 68% in fish intake assessment for mercury effect on neurobehavioural tests $15,660
Initial family doctor appointment needed for each Hg(B) screening $35,900
Probabilistic sensitivity analysis
Average incremental cost per QALY (ICUR) $18,209
ICUR, 5th percentile $9,339
ICUR, 95th percentile $56,555
Incremental net benefit gained versus reference case, for Can$20,000/QALY $3.10
INB, 5th percentile –$20.01
INB, 95th percentile $36.53
Incremental net benefit gained versus reference case, for Can$50,000/QALY $54.96
INB, 5th percentile –$3.56
INB, 95th percentile $139.08