TABLE 102Sensitivity analyses: nilotinib versus IFN for ImI patients

ParameterBase caseSensitivity analysisICER (£)
Base caseNANA104,698
General
Discounting3.5% p.a. costs and benefits0% p.a. costs and benefits88,863
Effectiveness
Time in post-progression survival8.7 years IFN, 5.8 years nilotinibNilotinib and IFN value equal to IFN value60,313
Dose intensityIFN 55.5%, nilotinib 100%IFN 100%, nilotinib 100%93,846
MCyR ratesNilotinib 46.5%Nilotinib 36.0% (lower 95% CI)150,683
Nilotinib 57.0% (upper 95% CI)82,034
Nilotinib 100% (maximum possible)48,132
IFN 22.1%IFN 18.6% (lower 95% CI)95,730
IFN 25.5% (upper 95% CI)115,915
OS HDI at 5 years0.6750.575 (lower 95% CI)102,595
0.775 (lower 95% CI)117,441
Hazard ratio responders vs non-responders0.370 (pooled mean)0.127 [lowest estimate identified: Kantarjian et al. (2006)236]69,906
0.156 (lower 95% of pooled estimate)73,485
0.876 (upper 95% of pooled estimate)292,414
0.893 [highest estimate identified: Kantarjian et al. (2004)251]306,842
Time in AP and BC0.8 years AP, 1.1 years BCHalf: 0.4 years AP, 0.5 years BC105,419
Double: 1.6 years AP, 2.2 years BC103,292
Age starting second-line treatment56 years52 years100,099
60 years110,273
Costs
PFSNilotinib PFS probability at 1.59 years = 0.830.75 (lower 95% CI)72,771
0.91 (upper 95% CI)152,763
IFN PFS probability at 1.75 years = 0.710.63 (lower 95% CI)112,457
0.78 (upper 95% CI)92,576
Premature discontinuation rate23.2% nilotinib, 55.3% IFN0% nilotinib, 0% IFN95,255
Time treatment stops for patients who discontinue prematurely3 months1 month105,174
5 months104,218
Medical management costsHalf all unit costs or frequencies of use104,756
Double all unit costs or frequencies of use104,582
Third-line treatment cost£1040/monthZero130,539
Health-state utilities
CP on treatment0.85 nilotinib, 0.71 IFN0.76 nilotinib, (BMS 0.85 response, 0.68 no response)

0.71 IFN
177,667
CP no treatment0.850.7079,878
AP0.730.60104,315
BC0.520.40104,217

NA, not applicable; p.a. per annum.

From: 5, Cost-effectiveness: chronic myeloid leukaemia in chronic phase

Cover of Dasatinib and Nilotinib for Imatinib-Resistant or -Intolerant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation
Dasatinib and Nilotinib for Imatinib-Resistant or -Intolerant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation.
Health Technology Assessment, No. 16.22.
Rogers G, Hoyle M, Thompson Coon J, et al.
Southampton (UK): NIHR Journals Library; 2012 Apr.
© 2012, Crown Copyright.

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