Beyond the cost-effectiveness acceptability curve: The appropriateness of rank probabilities for presenting the results of economic evaluation in multiple technology appraisal

The cost-effectiveness acceptability curve (CEAC) shows the probability that an option ranks first for net benefit. Where more than two options are under consideration, the CEAC offers only a partial picture of the decision uncertainty. This paper discusses the appropriateness of showing the full set of rank probabilities for reporting the results of economic evaluation in multiple technology appraisal (MTA). A case study is used to illustrate the calculation of rank probabilities and associated metrics, based on Monte Carlo simulations from a decision model. Rank probabilities are often used to show uncertainty in the results of network meta-analysis, but until now have not been used for economic evaluation. They may be useful decision-making tools to complement the CEAC in specific MTA contexts.