TABLE 81Univariate sensitivity analyses using TIDI

SaDescriptionTrtStochasticDeterministicDifference (absolute value)Difference (%)
QALYCost (£)ICERQALYCost (£)ICERQALYCost (£)ICERQALYCost (£)ICER
Average (SD)−0.12 (0.31)35 (2148)806 (4340)−2.16 (5.74)0.02 (2.84)4.75 (9.95)
1Base caseN5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.5868,638Ex dom6.37007568,465.66Ex dom−0.21−172−3.19−0.25
E7.00174,84117,8536.77594474,519.3319,023.27−0.23−3221170−3.21−0.436.56
I7.30888,44244,3267.06726988,103.6946,629.52−0.24−3382304−3.29−0.385.20
2Rebound in HAQ is small after withdrawal (base case = initial gain)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A7.22567,710Ex dom7.31495367,159.74Ex dom0.09−5501.25−0.81
E7.79273,70612,0357.92364172,933.0910,853.980.13−773−11811.69−1.05−9.81
I8.18887,17434,0068.34696086,335.0331,659.220.16−839−23471.94−0.96−6.90
3Rapid worsening in HAQ with no treatment (upper 95% of CI)N3.30944,434NA3.22545344,348.90−0.08−85−2.52−0.19
A4.96770,829Ex dom4.84218470,577.36Ex dom−0.12−252−2.51−0.36
E5.44776,98515,2215.31343276,540.6615,417.67−0.13−444197−2.45−0.581.29
I5.78690,60940,2485.64730690,066.2240,510.98−0.14−543263−2.40−0.600.65
4Log-PASI utility function (Abbott151) (base case linear)N4.55842,168NA5.84369641,817.641.29−35028.21−0.83
A6.00168,638Ex dom7.00518168,465.66Ex dom1.00−17216.73−0.25
E6.3974,84117,8357.31630374,519.3322,206.660.93−322437214.50−0.4324.51
I6.76988,44235,8987.64336588,103.6941,534.50.87−338563712.92−0.3815.70
5No correlation between PASI 75 and PsARC (base case = 0.4)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.57168,968Ex dom6.36120868,808.52Ex dom−0.21−159−3.19−0.23
E6.99774,99017,9796.77129774,673.9519,165.02−0.23−3161186−3.23−0.426.60
I7.30388,64144,5587.06212688,314.9046,903.65−0.24−3262346−3.30−0.375.26
6RCT results fully generalisable to clinical practice (no adjustment for placebo effect)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.63768,561Ex dom6.42990568,387.96Ex dom−0.21−173−3.12−0.25
E7.06874,75217,1786.84758674,426.2918,210.23−0.22−3261032−3.12−0.446.01
I7.38188,34443,3717.14659888,000.6745,397.44−0.23−3432026−3.18−0.394.67
9Exponential HAQ cost function (Abbott151) (base case linear)N5.17163,052NA5.05690863,146.27−0.1194−2.210.15
A6.58082,129Ex dom6.37007581,718.09Ex dom−0.21−411−3.19−0.50
E7.00186,50212,8136.77594485,961.4713,272.09−0.23−541459−3.21−0.623.58
I7.30899,04540,8787.06726998,402.1642,703.76−0.24−6431826−3.29−0.654.47
12Inpatient treatment for uncontrolled psoriasisN5.171151,496NA5.05690815,1186.30−0.11−310−2.21−0.20
A6.580165,28297876.370075165,046.8010,555.06−0.21−235768−3.19−0.147.85
I7.308175,15713,5577.067269174,843.2014,051.12−0.24−314494−3.29−0.183.64
E7.001178,530Dom6.775944178,192.40Dom−0.23−338−3.21−0.19
13Cost per 3 months per 1-unit change in HAQ is £183 (US data)42 (base case £103)N5.17152,548NA5.05690852,668.62−0.11121−2.210.23
A6.58077,518Ex dom6.37007577,868.59Ex dom−0.21351−3.190.45
E7.00183,22416,7616.77594483,422.6517,890.27−0.231991129−3.210.246.74
I7.30896,56243,4687.06726996,747.9945,740.41−0.241862272−3.290.195.23
14Change in utility per 1-unit change in HAQ is −0.45 (Wyeth153) (base case −0.29)N0.84642,168NA0.64924041,817.64−0.20−350−23.26−0.83
A2.90568,638Ex dom2.56454368,465.66Ex dom−0.34−172−11.72−0.25
E3.58974,84111,9133.22536474,519.3312,694.14−0.36−322781−10.13−0.436.56
I3.95488,44237,2803.56796388,103.6939,650.89−0.39−3382371−9.76−0.386.36
15HAQ improves while on drug (lower 95% of CI) (base case no change)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A7.84566,823Ex dom7.90326866,346.63Ex dom0.06−4760.74−0.71
E8.49272,70491948.56489072,046.828617.2580.07−657−5770.86−0.90−6.27
I8.95986,06528,6359.04618385,368.6327,679.200.09−696−9560.97−0.81−3.34
16High rate of withdrawal (upper 95% of CIN5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.30262,085Ex dom6.04647961,904.14Ex dom−0.26−181−4.05−0.29
E6.63566,60416,6906.34969666,326.5218,958.16−0.29−2772268−4.30−0.4213.59
I6.87677,32344,4516.56739477,024.6649,141.99−0.31−2984691−4.49−0.3910.55
17Low rate of withdrawal (lower 95% of CI)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.89176,566Ex dom6.74664376,437.41Ex dom−0.14−129−2.09−0.17
E7.41184,81119,0387.27359584,472.3719,242.56−0.14−339205−1.85−0.401.07
I7.793101,89044,7317.651982101,556.745,150.50−0.14−333420−1.81−0.330.94
18All treatments have the same probability of PsARC response at 3 monthsN5.19741,416NA5.05690841,817.64−0.14402−2.700.97
A7.10477,174Ex dom6.82708277,272.01Ex dom−0.2898−3.900.13
E7.23678,11517,9996.97041078,067.8718,944.44−0.27−47945−3.67−0.065.25
I7.31687,889122,0737.06726988,103.69103,611.90−0.25215−18,461−3.400.24−15.12
19All treatments have the same probability of psoriasis responses (PASI 50/75/90) at 3 monthsN5.27341,746NA5.05690841,817.64−0.2272−4.100.17
A6.72267,892Ex dom6.38891967,859.27Ex dom−0.33−33−4.96−0.05
E7.18672,83416,2546.83482672,816.4317,435.44−0.35−181181−4.89−0.027.27
I7.41487,95166,2197.06726988,103.6965,767.68−0.35153−451−4.680.17−0.68
20Cost of drugs as in Wyeth submission153N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.58065,847Ex dom6.37007565,677.86Ex dom−0.21−169−3.19−0.26
E7.00171,47816,0156.77594471,178.7917,080.00−0.23−2991065−3.21−0.426.65
I7.30892,63268,9447.06726992,271.6572,403.13−0.24−3603459−3.29−0.395.02
22All biologics have the same change in HAQ at 3 months for a PsARC responderN5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.65968,52617,7176.44805168,357.8919,078.01−0.21−1681361−3.17−0.257.68
E6.94974,92022,0566.70567674,616.4424,293.30−0.24−3042237−3.50−0.4110.14
I7.21788,57350,8066.95782488,254.9554,089.25−0.26−3183283−3.59−0.366.46
23Three vials of infliximab (base case four vials)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A6.58068,638Ex dom6.37007568,465.66Ex dom−0.21−172−3.19−0.25
E7.00174,841Ex dom6.77594474,519.33Ex dom−0.23−322−3.21−0.43
I7.30876,55016,8097.06726976,286.9417,145.82−0.24−263337−3.29−0.342.00
26Rebound to NH after withdrawal (base case: rebound to initial gain)N5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A5.84669,701Ex dom5.75607869,314.27Ex dom−0.09−387−1.54−0.55
E6.10476,14536,4086.03015275,550.0934659.80−0.07−595−1748−1.21−0.78−4.80
I6.30789,90067,7596.23570689,252.9966,663.29−0.07−647−1096−1.13−0.72−1.62
31No costs of psoriasis (base case: UK data187,192)N5.17128,908NA5.05690828,577.05−0.11−331−2.21−1.14
A6.58056,792Ex dom6.37007556,648.07Ex dom−0.21−144−3.19−0.25
E7.00162,20918,1966.77594461,912.5419,391.97−0.23−2961196−3.21−0.486.57
I7.30877,70450,4997.06726977,381.2853,097.84−0.24−3232599−3.29−0.425.15
32Schering-Plough estimates of cost per PASI point excluding phototherapy152N5.17155,479NA5.05690855,158.54−0.11−320−2.21−0.58
A6.58080,496Ex dom6.37007580,366.29Ex dom−0.21−130−3.19−0.16
E7.00187,252173616.77594486,959.4718,499.28−0.23−2931138−3.21−0.346.56
I7.30899,43839,7157.06726999,146.3941,832.70−0.24−2922118−3.29−0.295.33
33Schering-Plough estimates of cost per PASI point including phototherapy152N5.171112,633NA5.056908112,333.80−0.11−299−2.21−0.27
A6.580131,48213,3816.370075131,382.8014,506.15−0.21−991125−3.19−0.088.41
E7.001141,118Ex dom6.775944140,834Ex dom−0.23−284−3.21−0.20
I7.308146,18720,1887.067269145,961.9020,911.05−0.24−225723−3.29−0.153.58
34The effectiveness of biologic therapy lasts no longer than 10 years, compared with palliative careN5.17142,168NA5.05690841,817.64−0.11−350−2.21−0.83
A5.87566,044Ex dom6.73059176,090.30Ex dom0.8610,04614.5615.21
E6.13071,55630,6457.25234684,039.0019,231.401.1212,483−1141418.3117.45−37.24
I6.32583,77962,7467.626992100,971.1045,194.961.3017,192−1755120.5820.52−27.97

A, adulimamab; E, etanercept; I, infliximab; Ex dom; extended dominated; N, no treatment/palliative care; NA, not available; Sa, sensitivity analysis number; Trt, treatment.

From: Appendix 22, Sensitivity analysis comparing results from the stochastic and deterministic models

Cover of Etanercept, Infliximab and Adalimumab for the Treatment of Psoriatic Arthritis: A Systematic Review and Economic Evaluation
Etanercept, Infliximab and Adalimumab for the Treatment of Psoriatic Arthritis: A Systematic Review and Economic Evaluation.
Health Technology Assessment, No. 15.10.
Rodgers M, Epstein D, Bojke L, et al.
Southampton (UK): NIHR Journals Library; 2011 Feb.
© 2011, Crown Copyright.

Included under terms of UK Non-commercial Government License.

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