Objectives Economic appraisal of an intervention is a complex and multivariable problem, with probabilistic issues related not only to clinical outcomes but also to costs and willingness to pay. Methods We provide a comprehensive framework for economic appraisal of a health intervention to prevent beast cancer mortality, involving probabilistic model of costs as well as of aspects of the disease process. The economic appraisal can give a range of probabilities of cost-effectiveness depending on willingness or ability to pay. Results We apply the method to the example of polychemotherapy for early breast cancer. Results indicate a 30% probability of cost-effectiveness for a willingness to pay of $60 000 per quality-adjusted life-year and around 50% for a threshold of $100 000. Conclusion The comprehensive economic appraisal model is a powerful tool for decision making over a range of economic environments.
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