Analysis at 12 months For children with intractable epilepsy, 34% of the patients on KD were responders (i.e. 50% or more seizure reduction), resulting on average in 0.693 QALYs per patient. The expected health care costs were D 14,036 per patient over 12 months. VNS therapy yielded less responders (27%) and less QALYs (0.688) and was more expensive (D 19,922). Comparing KD with VNS, KD dominated VNS in terms of cost per QALY and per responder, as KD is less costly and more effective. CAU was the least effective (0.662 QALYs and 8% responders) and also the least expensive therapy (D 3306). Comparing KD with CAU resulted in an ICER of D 346,899 perQALY gained (i.e. more effects at higher costs). The ICERS are presented in Table 3.