Cost-effectiveness analysis planning and calculation worksheet

Defining the alternatives and their common outcome indicator at the outset affects the quality of the entire analysis. Always record the evidence supporting cost and effect data before calculating ICER.

When to use this worksheet and what completion involves Fictional completed example

EvalCompass Worksheet

Cost-effectiveness analysis planning and calculation worksheet

Method: Cost-Effectiveness Analysis

Basic information

Record the assumptions for the analysis.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

Program or intervention name: Application support A/B
Analytical perspective: provider or societal: Provider perspective
Comparator: Current option A
Outcome indicator in natural units: Number of additional people completing applications
Analysis period: The same period within 1 year
Prepared by and date: Staff member A / July 2026 (fictional)

Reason for this entry: Align the units using additional effects relative to usual practice.

Program or intervention name

Analytical perspective: provider or societal

Comparator

Outcome indicator in natural units

Analysis period

Prepared by and date

Writing tips and explanation for this section

About this section

Record the assumptions for the analysis.

Align the units using additional effects relative to usual practice.

View the method explanation

Writing tips

Follow each field’s heading to record the program name, focus, period, and other details. Leave undecided matters clearly marked as unresolved.

Read the full fictional example

Costs and effects by alternative

Record the costs and outcomes for each alternative.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

Scroll horizontally to view the table

Alternative	Total direct costs	Indirect costs, if any	Total costs	Outcome quantity in natural units	Source of cost data
A	JPY 100,000	JPY 0; items outside the provider perspective are recorded separately	JPY 100,000	10 people	Fictional costs
B	JPY 160,000	JPY 0; items outside the provider perspective are recorded separately	JPY 160,000	20 people	Fictional costs

Reason for this entry: State the limitations of a perspective that excludes service users' time.

Scroll horizontally to view the table

Alternative	Total direct costs	Indirect costs, if any	Total costs	Outcome quantity in natural units	Source of cost data

Writing tips and explanation for this section

About this section

Record the costs and outcomes for each alternative.

State the limitations of a perspective that excludes service users' time.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

CER and ICER calculations

Record the cost-effectiveness ratio and incremental cost-effectiveness ratio.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

Scroll horizontally to view the table

Comparison pair: A vs B	Cost difference (ΔC)	Effect difference (ΔE)	ICER（ΔC÷ΔE）	Threshold used	Adoption decision
B vs A	JPY 60,000	10 people	JPY 6,000 per additional person	Not set. Consider stakeholders' opportunity costs and budget.	Adoption remains undecided on this table alone.

Reason for this entry: Do not set a threshold without a basis.

Scroll horizontally to view the table

Comparison pair: A vs B	Cost difference (ΔC)	Effect difference (ΔE)	ICER（ΔC÷ΔE）	Threshold used	Adoption decision

Writing tips and explanation for this section

About this section

Record the cost-effectiveness ratio and incremental cost-effectiveness ratio.

Do not set a threshold without a basis.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

Cost breakdown for the main alternatives

Check all cost items comprehensively to prevent understatement.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

Scroll horizontally to view the table

Cost category	Include or exclude	Amount	Evidence and calculation method
Personnel, training and operation	Include	B total: JPY 160,000	Total fictional estimate. Check the breakdown and duplication in a real analysis.

Reason for this entry: Check that no necessary costs are omitted.

Scroll horizontally to view the table

Cost category	Include or exclude	Amount	Evidence and calculation method

Writing tips and explanation for this section

About this section

Check all cost items comprehensively to prevent understatement.

Check that no necessary costs are omitted.

View the method explanation

Writing tips

Keep the information in each row aligned. Scroll wide tables horizontally to see every column.

Read the full fictional example

Sensitivity analysis settings

Record the ranges for key parameters and the sensitivity analysis method.

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

If B produces 15 additional people completing applications, the difference from A is 5 people and ICER is JPY 12,000 per person. Prioritize examining uncertainty in the effect difference.

Reason for this entry: Show sensitivity to effects as well as costs.

Writing tips and explanation for this section

About this section

Record the ranges for key parameters and the sensitivity analysis method.

Show sensitivity to effects as well as costs.

View the method explanation

Writing tips

Use the example as a reference and record what you have established about your own program. Distinguish assumptions and unchecked matters from confirmed facts.

Read the full fictional example

Completion check

Completed example for this section (fictional)

This fictional example is for explanation. Adapt it to your own program. Your entries will not change.

☑ Checked: Documented the basis for selecting the comparator
☑ Checked: Applied the same outcome indicator to all alternatives
☑ Checked: Included personnel, training and system costs
☑ Checked: Stated the limits of causal attribution in the effect data
☐ Not checked: Specified the ICER threshold and its basis
☑ Checked: Conducted sensitivity analysis and reported the results

Reason for this entry: No uniform adoption threshold is set. Also state limitations where effects represent only observed differences.

Documented the basis for selecting the comparator
Applied the same outcome indicator to all alternatives
Included personnel, training and system costs
Stated the limits of causal attribution in the effect data
Specified the ICER threshold and its basis
Conducted sensitivity analysis and reported the results

Writing tips and explanation for this section

About this section

No uniform adoption threshold is set. Also state limitations where effects represent only observed differences.

View the method explanation

Writing tips

Read each item and check those you have confirmed. Do not use the fictional example’s checkbox states as findings about your own program.

Read the full fictional example

Before writing, check when to use the worksheet and what completion involves

Cost-effectiveness analysis planning and calculation worksheet is a worksheet for applying Cost-Effectiveness Analysis in meetings or individual work. For the overall duration of the method, use “Planning example, not a universal standard duration: 2 weeks–3 months, including outcome data collection and analysis” as a reference, adjusting for scale and resources. Fill in what you know provisionally and leave unresolved matters as questions to check next.

When this worksheet is useful

When you want to compare the cost efficiency of interventions or programs pursuing the same goal and select the most efficient approach
When deciding which interventions should receive priority for limited resources under a budget constraint
When monetizing outcomes in health care, welfare or education is ethically or politically difficult to accept

Participants and preparation

Evaluation lead for economic analysis, program staff providing cost data, and a statistician estimating effect sizes. Review by relevant specialists, such as in health care or education, is desirable.

Bring the materials used for decisions, existing data, and differing stakeholder views to help complete the worksheet.

Suggested order

1. Basic informationRecord the assumptions for the analysis.
2. Costs and effects by alternativeRecord the costs and outcomes for each alternative.
3. CER and ICER calculationsRecord the cost-effectiveness ratio and incremental cost-effectiveness ratio.
4. Cost breakdown for the main alternativesCheck all cost items comprehensively to prevent understatement.
5. Sensitivity analysis settingsRecord the ranges for key parameters and the sensitivity analysis method.
6. Completion check

Signs the worksheet is ready for review

Cost and effect data table by alternative
CER and ICER calculation table
Sensitivity analysis, including a cost-effectiveness plane and CEAC for probabilistic sensitivity analysis

Cautions for review

An inappropriate ICER comparator or baseline changes the overall conclusion. Doing nothing under current conditions and using the best existing approach produce entirely different ICERs.
When effect data come from observational studies, findings are often reported with insufficient adjustment for selection bias. Overestimated effects artificially lower ICER.
Understating costs by omitting implementation costs, such as personnel, training and system development, makes cost-effectiveness appear better.

Read a completed fictional example (your entries will not change)

Fictional example; not actual results

A fictional illustrative example comparing options A and B for the same population and period, with additional people completing applications as the effect.

Basic information

Program or intervention name: Application support A/B
Analytical perspective: provider or societal: Provider perspective
Comparator: Current option A
Outcome indicator in natural units: Number of additional people completing applications
Analysis period: The same period within 1 year
Prepared by and date: Staff member A / July 2026 (fictional)

Reason for this entry: Align the units using additional effects relative to usual practice.

Costs and effects by alternative

Scroll horizontally to view the table

Alternative	Total direct costs	Indirect costs, if any	Total costs	Outcome quantity in natural units	Source of cost data
A	JPY 100,000	JPY 0; items outside the provider perspective are recorded separately	JPY 100,000	10 people	Fictional costs
B	JPY 160,000	JPY 0; items outside the provider perspective are recorded separately	JPY 160,000	20 people	Fictional costs

Reason for this entry: State the limitations of a perspective that excludes service users' time.

CER and ICER calculations

Scroll horizontally to view the table

Comparison pair: A vs B	Cost difference (ΔC)	Effect difference (ΔE)	ICER（ΔC÷ΔE）	Threshold used	Adoption decision
B vs A	JPY 60,000	10 people	JPY 6,000 per additional person	Not set. Consider stakeholders' opportunity costs and budget.	Adoption remains undecided on this table alone.

Reason for this entry: Do not set a threshold without a basis.

Cost breakdown for the main alternatives

Scroll horizontally to view the table

Cost category	Include or exclude	Amount	Evidence and calculation method
Personnel, training and operation	Include	B total: JPY 160,000	Total fictional estimate. Check the breakdown and duplication in a real analysis.

Reason for this entry: Check that no necessary costs are omitted.

Sensitivity analysis settings

If B produces 15 additional people completing applications, the difference from A is 5 people and ICER is JPY 12,000 per person. Prioritize examining uncertainty in the effect difference.

Reason for this entry: Show sensitivity to effects as well as costs.

Completion check

☑ Checked: Documented the basis for selecting the comparator
☑ Checked: Applied the same outcome indicator to all alternatives
☑ Checked: Included personnel, training and system costs
☑ Checked: Stated the limits of causal attribution in the effect data
☐ Not checked: Specified the ICER threshold and its basis
☑ Checked: Conducted sensitivity analysis and reported the results

Reason for this entry: No uniform adoption threshold is set. Also state limitations where effects represent only observed differences.

Common errors in judgment

Treating the difference between each option's average ratios as ICER

How to revise: Divide the cost difference by the effect difference.

Reason: ICER is not the subtraction of two ratios.

Always adopting the cheaper option even if it has a smaller effect

How to revise: Consider the effect forgone, cost savings and opportunity costs.

Reason: A low cost alone does not establish contribution to the goal.

Editorial and checking information

Content updated: 2026-09-13Source checked: 2026-09-13 (includes AI cross-checking)No documented human reviewIncludes fictional examplesEditorial policy and scope of checking Cite this page Report a correction

References and checked sections

Developing NICE guidelines: Incorporating economic evaluation
National Institute for Health and Care Excellence
Section consulted
Presentation of results / incremental approach
How it relates to the text
When comparing alternatives, examine incremental costs and effects between appropriate comparators, not only total cost divided by total effect.
Source checked: 2026-09-13 (includes AI cross-checking)

How to cite this page

EvalCompass Editorial Team. “Cost-effectiveness analysis planning and calculation worksheet”. EvalCompass, updated 2026-09-13. https://evalcompass.jun-nakatani.com/en/worksheets/cea/

Add the date you accessed the page. Text created by this site is available under CC BY 4.0. Quotations, external materials, and bundled fonts have their own terms of use. When reusing content, credit the source, link to the license, and indicate any changes.

Suggest a correction or improvement to this page

Change history

2026-09-13 — Checked sources for definitions and applicability conditions, and added fictional examples, reasons for judgments and examples for every worksheet field. Revised unverified claims about history and adoption. Also reviewed existing procedures and cautions, and adjusted fixed participant counts and thresholds and generalizations about institutions.