Cost-utility analysis of certolizumab pegol versus alternative tumour necrosis factor inhibitors available for the treatment of moderate-to-severe active rheumatoid arthritis in Spain

Hidalgo-Vega, Álvaro; Villoro, Renata; Blasco, Juan Antonio; Talavera, Pablo; Ferro, Belén; Purcaru, Oana

doi:10.1186/s12962-015-0037-9

Cost Effectiveness and Resource Allocation

Table 7 One way sensitivity analysis for the ICER of certolizumab pegol + MTX vs. combination therapies

From: Cost-utility analysis of certolizumab pegol versus alternative tumour necrosis factor inhibitors available for the treatment of moderate-to-severe active rheumatoid arthritis in Spain

Parameter	Base case estimate	Sensitivity estimate	Comparator to certolizumab pegol (incremental cost per QALY gained)
Parameter	Base case estimate	Sensitivity estimate	Adalimumab (every 2 weeks) + MTX	Adalimumab (weekly) + MTX	Etanercept + MTX	Infliximab (3 mg/kg) + MTX	Infliximab (5 mg/kg) + MTX
Base case results			12,346	CZP dominates	CZP dominates	15,414	CZP dominates
Time horizon	Lifetime	5 years	36,676	CZP dominates	406,743	27,472	CZP dominates
Time horizon	Lifetime	10 years	29,024	CZP dominates	87,096	24,861	CZP dominates
Discount rate	Costs and QALYs 3.5 %	Costs 1.5 % and QALYs 1.5 %	7736	CZP dominates	CZP dominates	12,924	CZP dominates
		Costs 1.5 % and QALYs 6 %	9815	CZP dominates	CZP dominates	15,596	CZP dominates
		Costs 6 % and QALYs 1.5 %	13,621	CZP dominates	6372	14,747	CZP dominates
		Costs 6 % and QALYs 6 %	17,281	CZP dominates	11,624	17,796	CZP dominates
Inflation	3.0 %	0 %	14,385	CZP dominates	CZP dominates	CZP dominates	CZP dominates
ACR response	6 months	3 months	996^a	78.117^a	CZP dominates	5461	CZP dominates
Baseline HAQ score	1.6	1	32,708^a	565.932^a	8459	50,134	123,991^a
Baseline HAQ score	1.6	2.5	13,742	CZP dominates	46,630	14,677	CZP dominates
Administration Cost of IV medication in day hospital	214,54 €	+20 % (257,44 €)	subcutaneous injections	subcutaneous injections	subcutaneous injections	13,309	CZP dominates
Administration Cost of IV medication in day hospital	214,54 €	−20 % (171,63 €)	subcutaneous injections	subcutaneous injections	subcutaneous injections	17,519	CZP dominates
Rebound assumption, back to baseline	100 %	50 %	58,330	CZP dominates	106,252	46,733	25,385
Perspective	SNS	Societal	CZP dominates	CZP dominates	CZP dominates	CZP dominates	CZP dominates
Drug costing	Per mg	Per unit	12,821	CZP dominates	CZP dominates	29,538	CZP dominates
Principle QoL instrument	EQ-5D	HAQ DI	9791	CZP dominates	28,013	8709	CZP dominates
Association between HAQ DI and mortality	RR of 1.33 per HAQ DI increment	No association (RR of 1)	7766	CZP dominates	CZP dominates	12,608	CZP dominates

^aICER is of etanercept + MTX, infliximab + MTX or rituximab + MTX versus CZP + MTX, rather than vice versa, as elsewhere

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ISSN: 1478-7547

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