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Appendix C: Economic evaluation of testing strategies for hyperbilirubinaemia

Figure C.4 Comparing the incremental costs of TCB with TSB, varying the number of TCB meters
needed to deliver the strategy and the cost of the TCB meter

Figure C.5 Comparing the incremental costs of TCB with TSB, varying the number of TCB meters
needed to deliver the strategy and the mean number of tests per baby tested

C.7.3 Simultaneously varying the QALY gain and cost averted of a kernicterus case
These are important unknowns because together with effect size they are fundamental
determinants of whether increased testing costs represent a good use of scarce NHS resources. The
greater the QALY gain associated with an averted kernicterus case, the greater the NHS would be
willing to pay for such a gain. The greater the saving from an averted kernicterus case, the more
the additional costs of testing will be offset by a reduction in ‘downstream’ treatment costs.
Figures C.6 and C.7 show that the number of kernicterus cases that would need to be averted
for the TCB strategy to be considered cost-effective is very sensitive to the costs of a kernicterus
case. A high cost of kernicterus implies that a much lower number of cases would need to be
averted in order to meet NICE criteria for cost-effectiveness. By comparison, increasing the
QALY gain associated with an averted case has only a relatively small impact on the threshold

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