Diagnose Iron Deficiency
Compare testing strategies by detection, missed cases, cost, and modeled value.
Preferred strategy
Ferritin ≤50 ng/mL
Total cost
$765,016
diagnostic + downstream
Cases detected
1,056
of ~1,200 true cases
Missed cases
144
False positives
2,200
Incremental NMB
$3.67M
ICER vs comparator
$-2,998 / QALY
Cost per case detected
$724
Primary results table
| Strategy | Sens. | Spec. | Testing $ | TP | FP | FN | Total cost | QALYs | Δ Cost | Δ QALYs | ICER | NMB | Decision |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ferritin ≤15 ng/mL | 55.0% | 96.0% | $420,000 | 660 | 352 | 540 | $871,870 | 11.40 | $0 | 0.00 | Dominant (lower cost, higher QALYs) | $268,130 | Higher cost / lower value |
| Ferritin ≤30 ng/mL | 78.0% | 88.0% | $420,000 | 936 | 1,056 | 264 | $765,276 | 36.24 | -$106,594 | 24.84 | $-4,291 / QALY | $2.86M | Higher cost / lower value |
| Ferritin ≤50 ng/mL | 88.0% | 75.0% | $420,000 | 1,056 | 2,200 | 144 | $765,016 | 47.04 | -$106,854 | 35.64 | $-2,998 / QALY | $3.94M | Preferred |
| Ferritin + TSAT | 86.0% | 84.0% | $800,000 | 1,032 | 1,408 | 168 | $1.11M | 44.88 | $242,222 | 33.48 | $7,235 / QALY | $3.37M | Higher cost / lower value |
| Inflammation-adjusted Ferritin + TSAT + CRP | 90.0% | 82.0% | $1.12M | 1,080 | 1,584 | 120 | $1.42M | 49.20 | $546,630 | 37.80 | $14,461 / QALY | $3.50M | Higher cost / lower value |
Cases detected by strategy
Classification breakdown
Total cost by strategy
Cost vs QALYs (cost-effectiveness plane)
Net monetary benefit by strategy
Tornado: drivers of NMB (preferred strategy)
NMB across WTP thresholds
Interpretation
At the selected willingness-to-pay threshold of $100,000 per QALY, Ferritin ≤50 ng/mL has the highest net monetary benefit in this illustrative scenario for the General US adults cohort. This result is driven by the balance between case detection (1,056 of 1,200 true cases) and downstream costs, including missed-diagnosis costs and unnecessary-treatment costs from false positives.
The ICER versus the selected comparator (Ferritin ≤15 ng/mL) is $-2,998 / QALY. Tornado analysis shows the result is most sensitive to changes in missed-diagnosis cost and utility gain assumptions.
Results are generated from an illustrative demonstration model and should not be interpreted as final clinical, policy, or economic conclusions.