A systematic review of the effectiveness of adalimumab

TABLE 54 Base case: TNF inhibitors last (20,000 patients)
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Health Technology Assessment 2006; Vol. 10: No. 42
Option Cost (£) QSE QALYs QSE
Adal 36,176 215 1.8631 0.0218
Etan 49,208 262 2.9877 0.0267
Adal+MTX 36,420 216 2.1607 0.0223
Etan+MTX 49,390 263 2.9836 0.0271
Infl+MTX 36,430 209 1.9166 0.0225
Base 2,857 11 1.0317 0.0182
Comparison Diff. cost (£) QSE Diff. QALY QSE
Adal – Base 33,319 213 0.8314 0.0159
Etan – Base 46,352 260 1.9560 0.0228
Ad+M – Base 33,563 214 1.1290 0.0171
Et+M – Base 46,534 260 1.9519 0.0234
In+M - Base 33,574 207 0.8848 0.0169
Ad+M – Adal 244 294 0.2976 0.0204
Et+M – Etan 182 348 –0.0041 0.0297
Etan – Adal 13,033 323 1.1246 0.0251
Et+M – Ad+M 12,970 325 0.8229 0.0264
In+M – Ad+M 11 290 –0.2442 0.0212
Et+M – In+M 12,960 318 1.0670 0.0261
Comparison ICER (£/QALY) Quasi-CI
Adal – Base 40,100 38,500 to 41,800
Etan – Base 23,700 23,100 to 24,300
Ad+M – Base 29,700 28,800 to 30,700
Et+M – Base 23,800 23,200 to 24,500
In+M – Base 37,900 36,500 to 39,500
Ad+M – Adal Adal+MTX more effective than Adal alone; diff. cost not significant
Et+M – Etan Comparison is inconclusive
Etan – Adal 11,600 10,800 to 12,400
Et+M – Ad+M 15,800 14,600 to 17,200
In+M – Ad+M Adal+MTX more effective than Infl+MTX; diff. cost not significant
Et+M – In+M 12,100 11,300 to 13,000
TABLE 55 Summary ICERs for sequential use of two TNF inhibitors
First TNF inhibitor used Following TNF inhibitor ICER (£ per QALY)
Adal (alone) Etan 52,000
Infl 240,000
Etan (alone) Adal 240,000
Infl 190,000
Infli (with MTX) Adal 140,000
Etan 47,000
105