Table 1.
Clinical outcomes and costs over 30 years: alternative scenarios
| Base case scenario |
Ignoring irreversible damage | Ignoring impact of mortality | Use 70% Response criterion |
Less pronounced relationship between HAQ and utility |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| MTX only | ADA+MTX | MTX only | ADA+MTX | MTX only | ADA+MTX | MTX only | ADA+MTX | MTX only | ADA+MTX | |
| Life-years | ||||||||||
| Initial therapy | 6.62 | 13.32 | 9.87 | 13.42 | 12.05 | 17.83 | 3.82 | 8.89 | 6.39 | 12.77 |
| Therapy 2 | 2.47 | 2.67 | 3.92 | 4.46 | 6.35 | 6.65 | 2.17 | 3.04 | 2.86 | 2.83 |
| Therapy 3 | 1.14 | 0.86 | 2.24 | 1.66 | 3.25 | 2.72 | 1.42 | 1.48 | 1.13 | 0.85 |
| Therapy 4 | 2.60 | 0.92 | 3.68 | 1.69 | 8.35 | 2.80 | 5.51 | 2.85 | 2.22 | 0.90 |
| Total life-years | 12.83 | 17.75 | 19.71 | 21.23 | 30.00 | 30.00 | 12.93 | 16.26 | 12.61 | 17.34 |
| Total life-years discounted | 9.94 | 12.62 | 13.59 | 14.36 | 18.72 | 18.72 | 9.99 | 11.79 | 9.76 | 12.39 |
| Total QALYs discounted | 3.79 | 6.83 | 7.65 | 8.90 | 4.67 | 8.33 | 3.86 | 5.99 | 5.82 | 8.26 |
| Costs (discounted), £ | ||||||||||
| Medication | 2 589 | 108 805 | 2 603 | 110 147 | 5 940 | 135 247 | 4 222 | 74 589 | 2 469 | 104 655 |
| Hospital days | 43 467 | 35 897 | 36 552 | 27 012 | 118 078 | 74 388 | 43 053 | 37 232 | 43 134 | 35 417 |
| GP visits | 1 551 | 1 462 | 1 481 | 1 392 | 3 619 | 2 614 | 1 543 | 1 461 | 1 534 | 1 441 |
| Total costs | 47 607 | 146 164 | 40 636 | 138 551 | 127 637 | 212 249 | 48 817 | 113 282 | 47 137 | 141 513 |
| Costs per QALY, £ | 32 425 | 78 809 | 23 110 | 30 198 | 38 611 | |||||
ADA, adalimumab; GP, general practitioner; MTX, methotrexate; QALY, quality-adjusted life-year.