Table 4.
Probabilistic Sensitivity Analysis Results: Cohort of Initially Transfusion-Naive Chronically Transfused Sickle Cell Patients
| Time Period | Strategy
|
|||
|---|---|---|---|---|
| History-Based Matching
|
Prospective Matching
|
|||
| 1: Limited | 2: Extended | 3: Limited | 4: Extended | |
|
|
|
|||
| 10 years | ||||
| Total Cost per Transfused Unit: All Patients ($)a | 253.33 [218.83, 289.13] | 304.06 [262.36, 345.24] | 367.99 [320.51, 418.92] | 583.26 [503.49, 666.25] |
| Cost of Testing | 19.49 [16.75, 22.28] | 19.48 [16.78, 22.24] | 18.35 [15.86, 20.98] | 16.83 [14.48, 19.22] |
| Cost of Units | 233.49 [199.11, 269.32] | 284.46 [242.81, 325.50] | 349.38 [302.15, 400.83] | 566.42 [484.37, 650.41] |
| Cost of Complications | 0.35 [0.25, 0.46] | 0.12 [0.08, 0.17] | 0.26 [0.17, 0.37] | 0.02 [0.01, 0.03] |
| Entire SCD Cohort (National)b | ||||
| Total Cost (millions, $) | 1746.98 [1460.89, 2059.62] | 2113.27 [1772.12, 2483.83] | 2551.05 [2161.97, 2988.67] | 4073.02 [3396.32, 4792.12] |
| Net Change (Extended vs. Limited)c | 366.29 [351.67, 380.92] | 1521.97 [420.66, 454.90] | ||
| Net Change (Prospective vs. History-Based)d | 804.08 [788.04, 820.11] | 1959.75 [1934.80, 1984.70] | ||
| Alloimmunization Events | 11587.11 [9029.94, 14291.35] | 3123.06 [2776.06, 3487.79] | 9452.74 [6893.78, 12216.03] | 630.28 [445.80, 840.90] |
| Net Change (Extended vs. Limited)c | −8464.06 [−8553.23, −8374.90] | −8822.46 [−8912.34, −8732.58] | ||
| Net Change (Prospective vs. History-Based)d | −2134.38 [−2260.35, −2008.40] | −2492.77 [−2505.42, −2480.12] | ||
| Cost per Alloimmunization Event Avoided: Extended vs. Limited (thousands, $) | 43.28 [14.47, 72.09] | 172.51 [117.49, 227.53] | ||
| Cost per Alloimmunization Event Avoided: Prospective vs. Limited (thousands, $) | 376.73 [−1.70, 755.16] | 786.17 [612.43, 959.92] | ||
| 20 years | ||||
| Total Cost per Transfused Unit: All Patientsa | 220.88 [189.38, 253.69] | 266.41 [228.82, 303.37] | 319.01 [274.99, 362.85] | 505.86 [431.60, 580.45] |
| Cost of Testing | 15.97 [13.88, 18.12] | 15.96 [13.87, 18.07] | 15.35 [13.32, 17.37] | 13.81 [11.89, 15.74] |
| Cost of Units | 204.62 [173.24, 237.72] | 250.38 [213.10, 287.05] | 303.42 [260.48, 347.92] | 492.03 [418.13, 566.76] |
| Cost of Complications | 0.29 [0.20, 0.40] | 0.07 [0.04, 0.09] | 0.25 [0.17, 0.35] | 0.02 [0.01, 0.03] |
| Entire SCD Cohort (National)b | ||||
| Total Cost (millions, $) | 3062.88 [2556.47, 3603.88] | 3716.09 [3097.83, 4319.63] | 4449.14 [3750.08, 5195.19] | 7104.07 [5936.56, 8397.29] |
| Net Change (Extended vs. Limited)c | 653.21 [351.67, 380.92] | 2654.93 [420.66, 454.90] | ||
| Net Change (Prospective vs. History-Based)d | 1386.27 [788.04, 820.11] | 3387.99 [1934.80, 1984.70] | ||
| Alloimmunization Events | 18842 [14143.70, 24564.27] | 3613 [3203.90, 4112.99] | 16681 [11878.90, 22386.42] | 1106 [801.43, 1435.17] |
| Net Change (Extended vs. Limited)c | −15230 [−8553.23, −8374.90] | −15575 [−8912.34, −8732.58] | ||
| Net Change (Prospective vs. History-Based)d | −2162 [−2260.35, −2008.40] | −2507 [−2505.42, −2480.12] | ||
| Cost per Alloimmunization Event Avoided: Extended vs. Limited (thousands, $) | 42.89 [14.20, 71.58] | 170.46 [114.93, 226.00] | ||
| Cost per Alloimmunization Event Avoided: Prospective vs. Limited (thousands, $) | 641.26 [−480.74, 1763.27] | 1351.56 [1029.50, 1673.62] | ||
a
Total cost per transfused unit reflects the average expected cost per unit transfused. Average across all patients in a cohort of initially transfusion-naïve SCD patients over a period of chronic transfusion.
b
Outcomes for an entire cohort of chronically transfused SCD patients. Assumes a population of 85,000 SCD patients, of which 10% are chronically transfused.
c
Net change calculated as: Extended-Limited.
d
Net change calculated as: Prospective-History-Based.