Table 4.

Transition probabilities used in the Markov process that vary by patient population

			Probability by treatment
	Population	Atomoxetine	IR-MPH	XR-MPH	No medication
Probability of response to treatment	1. Stimulant-naïve, not contra-indicateda	0.7051	0.7727	0.7727	NA
	2. Stimulant-failed, not contra-indicatedb	0.6346	NA	NA	0.3731
	3. Stimulant-naïve, contra-indicatedc	0.6667	NA	NA	0.423
Probability of relapse per 30-day periodd	1. Stimulant-naïve, non contra-indicated	0.0206	0.0206	0.0206	NA
	2. Stimulant-failed, non contra-indicated	0.0257	NA	NA	0.0447
	3. Stimulant-naïve, contra-indicated	0.0206	NA	NA	0.0387

Abbreviations: IR-MPH = immediate-release methylphenidate; XR-MPH = extended-release methylphenidate; NA = not applicable

a. Probabilities of response in stimulant-naïve patients are not contra-indicated are based on a meta-regression analysis [45] of response data from randomised active comparator trials of atomoxetine and MPH [39,46,47] (some are data on file). Assumption of parity between stimulants is based on head-to-head trials of IR-MPH and XR-MPH [24,26].

b. Probabilities of response in MPH-exposed (failed) patients in whom stimulants are not contra-indicated are derived and inferred from responder rates in a crossover trial of atomoxetine and XR-MPH [47]. A probability of response for 'no medication' is derived by applying the relative risk of repsonse for placebo versus atomxetine, drawn from the meta-regression analysis [45].

c. Probabilities of response in stimulant-naïve patients in whom stimulants are contra-indicated are based on responder rates from a randomised placebo-controlled trial of atomoxetine in patients with tics or Tourette's syndrome [41].

d. Probability of relapse = 1 - [(1-C)^(1/E)], where C = the proportion of patients relapsing and E = approximate total number of follow-up days, derived from a relapse prevention study [48], divided by the approximate number of days per Markov cycle. Parity is assumed between active medications.