A systematic review of the effectiveness of adalimumab
A systematic review of the effectiveness of adalimumab
A systematic review of the effectiveness of adalimumab
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
TABLE 141 Variation 12: TNF inhibitors last (20,000 patients) (cont’d)<br />
© Queen’s Printer and Controller <strong>of</strong> HMSO 2006. All rights reserved.<br />
Health Technology Assessment 2006; Vol. 10: No. 42<br />
Comparison ICER (£ per QALY) Quasi-CI<br />
Adal – Base 37,200 35,900 to 38,600<br />
Etan – Base 22,800 22,300 to 23,400<br />
Ad+M – Base 28,900 28,100 to 29,800<br />
Et+M – Base 23,000 22,500 to 23,600<br />
In+M – Base 36,600 35,300 to 38,000<br />
Ad+M – Adal Adal+MTX more effective than Adal alone; diff. cost not significant<br />
Et+M – Etan Comparison is inconclusive<br />
Etan – Adal 10,600 9,880 to 11,400<br />
Et+M – Ad+M 14,000 12,900 to 15,300<br />
Ad+M – In+M 3,240 1,160 to 5,330<br />
Et+M – In+M 11,200 10,400 to 12,000<br />
Variation 13<br />
In this variation, <strong>the</strong> possibility was considered <strong>of</strong> <strong>review</strong>ing <strong>the</strong> <strong>effectiveness</strong> <strong>of</strong> TNF inhibitors at 12<br />
weeks ra<strong>the</strong>r than at 24 weeks. For <strong>the</strong> purpose <strong>of</strong> this analysis, <strong>the</strong> proportion <strong>of</strong> short-term quitters was<br />
left unchanged.<br />
TABLE 142 Variation 13: TNF inhibitors first (4,000,000 patients)<br />
Option Cost (£) QSE QALYs QSE<br />
Adal 48,362 16 8.9326 0.0027<br />
Etan 63,011 20 9.2897 0.0028<br />
Adal+MTX 48,531 16 8.4856 0.0025<br />
Etan+MTX 63,129 20 8.9015 0.0027<br />
Infl+MTX 47,903 16 8.3299 0.0025<br />
Base 15,338 3 8.3150 0.0025<br />
Comparison Diff. cost (£) QSE Diff. QALY QSE<br />
Adal – Base 33,024 16 0.6176 0.0027<br />
Etan – Base 47,673 19 0.9747 0.0028<br />
Ad+M – Base 33,194 16 0.1706 0.0026<br />
Et+M – Base 47,791 19 0.5864 0.0027<br />
In+M – Base 32,566 15 0.0149 0.0026<br />
Ad+M – Adal 170 22 –0.4470 0.0027<br />
Et+M – Etan 118 26 –0.3882 0.0028<br />
Etan – Adal 14,649 24 0.3571 0.0028<br />
Et+M – Ad+M 14,598 25 0.4158 0.0027<br />
Ad+M – In+M 628 22 0.1557 0.0026<br />
Et+M – In+M 15,226 24 0.5716 0.0027<br />
Comparison ICER (£ per QALY) Quasi-CI<br />
Adal – Base 53,500 53,000 to 53,900<br />
Etan – Base 48,900 48,600 to 49,200<br />
Ad+M – Base 195,000 189,000 to 201,000<br />
Et+M – Base 81,500 80,700 to 82,300<br />
In+M – Base 2,190,000 1,620,000 to 3,380,000<br />
Ad+M – Adal Adal alone dominates Adal+MTX<br />
Et+M – Etan Etan alone dominates Etan+MTX<br />
Etan – Adal 41,000 40,400 to 41,700<br />
Et+M – Ad+M 35,100 34,600 to 35,600<br />
Ad+M – In+M 4,030 3,720 to 4,340<br />
Et+M – In+M 26,600 26,400 to 26,900<br />
211