TABLE 4.

Incremental Analysis

Strategy	Treatment Sequence	Incremental		ICER ($ per ACR20 Responder)
		Costs, $	ACR20 Responders	Versus Baseline,a $	Incremental, $
Tofacitinib comparator sequence 3	APR→TOF→ADA→SEC	N/A	N/A	N/A	N/A
Tofacitinib comparator sequence 1	TOF→ADA→ETA→APR	3,301,907	8	416,612	416,612
Tofacitinib comparator sequence 2	ADA→TOF→ETA→APR	6,547,825	8	844,671	Dominated
Treatment sequence excluding tofacitinib	ADA→ETA→APR→SEC	8,562,291	0	Dominated	Dominated

^aWithout tofacitinib in the treatment algorithm.

ACR20 = American College of Rheumatology response criteria of 20%; ADA = adalimumab; APR = apremilast; ETA = etanercept; ICER = incremental cost-effectiveness ratio; N/A = not applicable; SEC = secukinumab; TOF = tofacitinib.