Table 1. Transition probabilities and QALY estimates.
Transition probabilities and QALY estimates for both combination therapy and monotherapy. All transition probabilities were assessed via one-way sensitivity analysis over a range of +/− 25%. For QALY inputs used for the model, sensitivity analyses were conducted varying the value by +/− 15%.
| Transition probability for: | Value | Source |
|---|---|---|
| Remission with combination therapy with infliximab | 0.3254 | 1 |
| Clinical response with combination therapy with infliximab* | 0.3077 | 1 |
| Remission with combination therapy with adalimumab | 0.2192 | 17 |
| Flaring when in remission with combination therapy with infliximab, per year | 0.5385 | 1 |
| Flaring with clinical response with combination therapy with infliximab per year | 0.213 | 1 |
| Clinical response with combination therapy with adalimumab | 0.3836 | 17 |
| Adverse event requiring drug cessation with combination therapy with infliximab | 0.207 | 1 |
| Adverse event requiring drug cessation with combination therapy with adalimumab, per year | 0.058 | 18 |
| Infectious complication with combination therapy with infliximab per year | 0.0391 | 1 |
| Infectious complication with combination therapy with adalimumab per year | 0.0271 | 18 |
| Remission with monotherapy with infliximab | 0.2959 | 1 |
| Clinical response with monotherapy with infliximab* | 0.2485 | 1 |
| Remission with monotherapy with adalimumab | 0.2093 | 17 |
| Clinical response with monotherapy with adalimumab | 0.3736 | 17 |
| Flaring when in remission with monotherapy with infliximab, per year | 0.6509 | 1 |
| Flaring with clinical response with monotherapy with infliximab per year | 0.2784 | 1 |
| Adverse event requiring drug cessation with monotherapy with infliximab per year | 0.1779 | 1 |
| Adverse event requiring drug cessation with monotherapy with adalimumab per year | 0.058 | 18 |
| Flaring with clinical response with adalimumab per year | 0.5562 | 18 |
| Flaring in remission with adalimumab per year | 0.6795 | 18 |
| Infectious complication with monotherapy with infliximab per year | 0.0491 | 1 |
| Infectious complication with monotherapy with adalimumab per year | 0.0271 | 18 |
| Surgery during acute flare | 0.1 | 14 |
| Mortality rate with an infectious complication | 0.001 | 14 |
| QALY Estimates | ||
| Medical Remission | 0.89 | 14, 23 |
| Clinical Response | 0.76 | ** |
| Severe CD | 0.62 | 14, 23 |
| Surgical Remission | 0.8 | 14, 23 |
| Surgery | 0.25 | 14, 23 |
| Infectious Complication | 0.62 | 14, 23 |
| Adverse Event | 0.62 | 14, 23 |
| Lymphoma | 0.47 | 14, 23 |
*
Clinical response rates for combination therapy and monotherapy with infliximab were derived from residual response rates (CDAI decrease >100pts) after subtracting % with remission at 6 weeks in SONIC.
**
For clinical response, the average between medical remission and severe CD was used, per expert opinion.