Incremental cost The mean cost associated with one strategy minus the mean cost of a comparator strategy. Incremental effects The mean QALYs (or other selected measure of health outcome) associated with Chronic Heart Failure Methods NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Item Description one strategy minus the mean QALYs of a comparator strategy. Cost effectiveness Incremental cost-effectiveness ratio (ICER): the incremental cost divided by the incremental effects (usually in per QALY gained). Uncertainty A summary of the extent of uncertainty about the ICER reflecting the results of deterministic or probabilistic sensitivity analyses, or stochastic analyses of trial data, as appropriate. (a) Applicability and limitations were assessed using the economic evaluation checklist in appendix H of the NICE guidelines 4.4.2 Undertaking new health economic analysis As well as reviewing the published health economic literature for each review question, as described above, new health economic analysis was undertaken by the health economist in selected areas. Priority areas for new analysis were agreed by the committee after formation of the review questions and consideration of the existing health economic evidence. The committee identified determining a natriuretic peptide threshold for referral for echocardiography as the highest priority area for original health economic modelling. This was due to concerns that the current natriuretic peptide thresholds may be too high, resulting in delayed diagnosis, whilst also acknowledging that there could be significant increase in cost if the threshold were to be lowered and more patients were referred for echocardiography. The following general principles were adhered to in developing the cost-effectiveness analysis: Methods were consistent with the NICE reference case for interventions with health outcomes in The committee was involved in the design of the model, selection of inputs and interpretation of the results. 