A systematic review of the effectiveness of adalimumab

TABLE 105 Variation 3: TNF inhibitors last (20,000 patients) (cont’d)
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Health Technology Assessment 2006; Vol. 10: No. 42
Comparison ICER (£ per QALY) Quasi-CI
Adal – Base 64,100 59,700 to 69,100
Etan – Base 33,400 32,200 to 34,600
Ad+M – Base 43,000 40,900 to 45,400
Et+M – Base 34,000 32,800 to 35,300
In+M – Base 60,500 56,500 to 65,000
Ad+M – Adal Adal+MTX more effective than Adal alone; diff. cost not significant
Etan – Et+M Comparison is inconclusive
Etan – Adal 14,700 13,600 to 15,900
Et+M – Ad+M 21,200 19,100 to 23,700
In+M – Ad+M Adal+MTX more effective than Infl+MTX; diff. cost not significant
Et+M – In+M 15,300 14,200 to 16,800
Variation 4
For this variation, it was assumed that HAQ progression on all treatments was at 0.06 per year.
TABLE 106 Variation 4: TNF inhibitors first (1,000,000 patients)
Option Cost (£) QSE QALYs QSE
Adal 49,224 32 7.7643 0.0046
Etan 63,281 39 7.8800 0.0047
Adal+MTX 49,404 32 7.3785 0.0044
Etan+MTX 63,465 39 7.5377 0.0045
Infl+MTX 48,751 31 7.2236 0.0044
Base 15,234 7 7.3969 0.0044
Comparison Diff. cost (£) QSE Diff. QALY QSE
Adal – Base 33,990 31 0.3674 0.0049
Etan – Base 48,047 38 0.4830 0.0050
Ad+M – Base 34,170 32 –0.0185 0.0048
Et+M – Base 48,231 38 0.1408 0.0049
In+M – Base 33,517 30 –0.1733 0.0048
Ad+M – Adal 180 44 –0.3858 0.0049
Et+M – Etan 184 51 –0.3423 0.0050
Etan – Adal 14,057 47 0.1157 0.0050
Et+M – Ad+M 14,061 48 0.1592 0.0048
In+M – Ad+M 653 43 0.1548 0.0047
Et+M – In+M 14,714 47 0.3141 0.0048
Comparison ICER (£ per QALY) Quasi-CI
Adal – Base 92,500 90,100 to 95,100
Etan – Base 99,500 97,500 to 102,000
Ad+M – Base Base dominates Adal+MTX
Et+M – Base 343,000 320,000 to 368,000
In+M – Base Base dominates Infl+MTX
Ad+M – Adal Adal alone dominates Adal+MTX
Et+M – Etan Etan alone dominates Etan+MTX
Etan – Adal 122,000 112,000 to 133,000
Et+M – Ad+M 88,300 83,200 to 94,000
In+M – Ad+M 4,220 3,610 to 4,830
Et+M – In+M 46,900 45,400 to 48,400
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