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A systematic review of the effectiveness of adalimumab

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Appendix 10<br />

TABLE 95 Variation 1: TNF inhibitors third (early RA values) (20,000 patients)<br />

Option Cost (£) QSE QALYs QSE<br />

Adal 48,371 221 6.8542 0.0366<br />

Etan 61,650 271 7.7651 0.0413<br />

Adal+MTX 48,830 224 7.0461 0.0368<br />

Etan+MTX 61,349 270 7.8660 0.0416<br />

Infl+MTX 48,298 212 6.9820 0.0365<br />

Base 16,444 51 5.3484 0.0306<br />

Comparison Diff. cost (£) QSE Diff. QALY QSE<br />

Adal – Base 31,926 217 1.5058 0.0352<br />

Etan – Base 45,206 263 2.4167 0.0390<br />

Ad+M – Base 32,386 220 1.6977 0.0353<br />

Et+M – Base 44,905 262 2.5176 0.0397<br />

In+M – Base 31,854 208 1.6336 0.0352<br />

Ad+M – Adal 459 295 0.1919 0.0380<br />

Etan – Et+M 301 351 –0.1009 0.0440<br />

Etan – Adal 13,280 326 0.9109 0.0411<br />

Et+M – Ad+M 12,519 327 0.8199 0.0418<br />

In+M – Ad+M 532 289 0.0641 0.0383<br />

Et+M – In+M 13,051 321 0.8840 0.0415<br />

Comparison ICER (£ per QALY) Quasi-CI<br />

Adal – Base 21,200 20,200 to 22,300<br />

Etan – Base 18,700 18,100 to 19,400<br />

Ad+M – Base 19,100 18,300 to 19,900<br />

Et+M – Base 17,800 17,300 to 18,500<br />

In+M – Base 19,500 18,700 to 20,400<br />

Ad+M – Adal Adal+MTX more effective than Adal alone; diff. cost not significant<br />

Etan – Et+M Etan+MTX more effective than Etan alone; diff. cost not significant<br />

Etan – Adal 14,600 13,200 to 16,200<br />

Et+M – Ad+M 15,300 13,700 to 17,200<br />

In+M – Ad+M Comparison is inconclusive<br />

Et+M – In+M 14,800 13,300 to 16,500<br />

TABLE 96 Variation 1: TNF inhibitors third (late RA values) (40,000 patients)<br />

Option Cost (£) QSE QALYs QSE<br />

Adal 47,664 156 6.1760 0.0254<br />

Etan 60,598 191 7.2320 0.0286<br />

Adal+MTX 48,194 157 6.4741 0.0253<br />

Etan+MTX 60,894 191 7.2297 0.0289<br />

Infl+MTX 47,561 149 6.2132 0.0254<br />

Base 16,490 36 5.4254 0.0218<br />

Comparison Diff. cost (£) QSE Diff. QALY QSE<br />

Adal – Base 31,174 152 0.7506 0.0234<br />

Etan – Base 44,107 185 1.8066 0.0264<br />

Ad+M – Base 31,704 153 1.0487 0.0238<br />

Et+M – Base 44,404 186 1.8043 0.0268<br />

In+M – Base 31,071 145 0.7878 0.0237<br />

Ad+M – Adal 530 206 0.2981 0.0245<br />

Et+M – Etan 296 247 0.0023 0.0293<br />

Etan – Adal 12,934 228 1.0560 0.0269<br />

Et+M – Ad+M 12,700 230 0.7556 0.0276<br />

Ad+M – In+M 633 202 0.2609 0.0248<br />

Et+M – In+M 13,333 224 1.0165 0.0273<br />

continued

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