Table 4 Results of the Markov model over the five year time horizon for the reference case and for the five sensitivity analyses.
| Usual care | Etanercept | Infliximab | |
|---|---|---|---|
| Reference case | |||
| Months in BASDAI <4 over five years | 10.7 | 31.4 | 28.4 |
| Total QALY over five years | 2.89 | 3.16 | 3.11 |
| Total costs over five years (€) | 21 261 | 52 137 | 62 047 |
| Incremental cost‐utility ratio (€/QALY) | 118 022 | 189 564 | |
| Incremental cost (€) per extra month low disease activity | 1492 | 2307 | |
| Reference case with direct costs only | |||
| Total costs over five years | 19 425 | 49 555 | 59 574 |
| Incremental cost‐utility ratio (€/QALY) | 115 169 | 187 522 | |
| Reference case with human capital approach | |||
| Total costs over five years | 69 982 | 91 183 | 106 775 |
| Incremental cost‐utility ratio (€/QALY) | 81 038 | 171 848 | |
| Reference case with low dose infliximab | |||
| Total costs over five years (€) | 39 788 | ||
| Incremental cost‐utility ratio (€/QALY) | 86 533 | ||
| Reference case with two year time horizon | |||
| Months in BASDAI <4 over two years | 3.8 | 13.7 | 12.3 |
| Total QALY over two years | 1.26 | 1.39 | 1.37 |
| Total costs over two years (€) | 9462 | 25 675 | 31 972 |
| Incremental cost‐utility ratio (€/QALY) | 123 761 | 237 010 | |
| No response in health status in patients receiving usual care | |||
| Months in BASDAI <4 over five years | 0 | 29.7 | 26.3 |
| Total QALY over five years | 2.76 | 3.14 | 3.08 |
| Total costs over five years (€) | 23 307 | 52 458 | 62 448 |
| Incremental cost‐utility ratio (€/QALY) | 77 088 | 120 369 | |
| Best case analysis with probabilities (effectiveness, toxicity, and relapse) favouring TNFα inhibitors | |||
| Months in BASDAI <4 over five years | 4.4 | 48.2 | 44.3 |
| Total QALY over five years | 2.81 | 3.37 | 3.32 |
| Total costs over five years (€) | 22 473 | 67 418 | 82 601 |
| Incremental cost‐utility ratio (€/QALY) | 81 173 | 117 855 | |
| Best case analysis with costs and utilities favouring TNFα inhibitors | |||
| Total QALY over five years | 2.76 | 3.13 | 3.07 |
| Total costs over five years (€) | 27 478 | 54 595 | 65 052 |
| Incremental cost‐utility ratio (€/QALY) | 73 368 | 122 780 | |
| Best case analysis with probabilities, costs, and utilities favouring TNFα inhibitors | |||
| Total QALY over 5 years | 2.64 | 3.41 | 3.35 |
| Total costs over 5 years (€) | 29 811 | 66 891 | 82 787 |
| Incremental cost‐utility ratio (€/QALY) | 48 443 | 76 622 | |
| Best case with probabilities, costs, and utilities but no response in health status with usual care | |||
| Months in BASDAI <4 over five years | 0 | 47.6 | 43.2 |
| Total QALY over five years | 2.57 | 3.40 | 3.33 |
| Total costs over five years (€) | 31 426 | 67 139 | 83 173 |
| Incremental cost‐utility ratio (€/QALY) | 42 914 | 67 207 | |
| Reducing drug acquisition costs | 1/4 of the price | 1/5 of the price | |
| Total costs over five years (€) | 26 480 | 28 330 | |
| Incremental cost‐utility ratio (€/QALY) | 18 950 | 21 750 |
BASDAI: Bath ankylosing spondylitis disease activity index; QALY: quality adjusted life year.