TABLE 2.
Treatment-Related Model Inputs: Efficacy and Costs
| Parameter PSA Distribution | IAI 2q8 Value (Range) | Rq4 Value (Range) | Ranibizumab 0.5 mg PRN Value (Range) | |||
|---|---|---|---|---|---|---|
| Year 1 | Year 2+ | Year 1 | Year 2+ | Year 1 | Year 2+ | |
| Prob. improving ≥ 15 letters (normal) | 0.3514 (0.3115-0.3923)5 | 0.0a | ||||
| Prob. worsening ≥ 15 letters (normal) | 0.0467 (0.0305-0.0661)5 | 0.0a | ||||
| RR improving ≥ 15 lettersb (normal) | 1.021 (0.869-1.199)5 | 1.0c | 0.714 (0.527-0.969)d | 1.0c | ||
| RR worsening ≥ 15 lettersb (normal) | 1.193 (0.712-2.001)5 | 1.0c | 0.678 (0.281-1.637)d | 1.0c | ||
| Annual discontinuation risk (normal) | 0.0863 (0.0755-0.0977)5 | 0.0903 (0.0788-0.1025)21 | 0.0863 (0.0755-0.0977)c | 0.0903 (0.0788-0.1025)c | 0.0863 (0.0755-0.0977)c | 0.0903 (0.0788-0.1025)c |
| Number of injections | 7.5 (6-8)5 | 4.5 (3.6-5.4)33 | 11.7 (11.5-11.9)11 | 4.5 (3.6-5.4)c | 6.9 (5.5-8.3)11 | 4.5 (3.6-5.4)c |
| Monitoring costs (annual), $e | 1,509 (1,207-1,811) | 738 (591-886) | 2,198 (1,758-2,638) | 738 (591-886)c | 1,410 (1,128-1,693) | 738 (591-886)c |
| Acquisition costs (per injection), $f | 1,850 (1,480-2,220) | 1,950 (1,560-2,340) | 1,950 (1,560-2,340) | |||
aIt was assumed that patients remained at the current level of BCVA after the first year of treatment, unless treatment discontinuation occurred.
bIAI 2q8 was the reference treatment for the relative efficacy of ranibizumab Rq4 and PRN.
cAssumed to be the same as IAI 2q8.
dCalculated via Bucher indirect comparison using Rq4 as the common comparator.25
eResource unit cost (resource usage per year) used for annual monitoring costs for each treatment were as follows: (a) IAI 2q8 year 1: initial office visit $166.13 (1), subsequent office visit $108.13 (6.5), optical coherence tomography $55.94 (7.5), fluorescein angiography $220.35 (1); (b) Rq4 year 1: initial office visit $166.13 (1), subsequent office visit $108.13 (10.7), optical coherence tomography $55.94 (11.7), fluorescein angiography $220.35 (1); (c) ranibizumab PRN year 1: initial office visit $166.13 (1), subsequent office visit $108.13 (5.9), optical coherence tomography $55.94 (6.9), fluorescein angiography $220.35 (1); and (d) all treatments year 2+: subsequent office visit $108.13 (4.5), optical coherence tomography $55.94 (4.5).
fDrug acquisition costs were based on wholesale acquisition cost (from RED BOOK Online. 2016. Truven Health Analytics. Accessed July 20, 2016). BCVA = best-corrected visual acuity; IAI 2q8 = intravitreal aflibercept injection 2 mg every 4 weeks (monthly) for the first 12 weeks (3 months), followed by IAI 2 mg once every 8 weeks; Prob. = probability; PRN = pro re nata (i.e., as needed); PSA = probabilistic sensitivity analysis; Rq4 = ranibizumab 0.5 mg monthly; RR = relative risk.