(b).
Scenarios | ICER MMF versus AZA (US$) |
---|---|
Base-case (40-year time horizon) | $6,454.24 |
Excluding indirect costs | Dominanta |
Utility | |
Remission 0.8 (versus base-case 0.7) | $4067.55 |
Relapse 0.5 (versus base-case 0.6) | $5,808.27 |
Relapse 0.7 (versus base-case 0.6) | $7,695.58 |
Increase in probability of ESRD with relapse | |
0.5% per year | $4590.37 |
1.0% per year | $3112.96 |
2.0% per year | $2717.08 |
Extrapolated treatment effect after 3-year maintenance therapy | |
Same as during treatment phase (base-case) | $6,454.24 |
No treatment effect from both MMF and AZA during extrapolated phaseb | $428,894.16 |
Treatment effect from both MMF and AZA decreases 1% per yearc | $15,096.38 |
Treatment effect from both MMF and AZA decreases 2% per yearc | $25,713.36 |
Time horizon (number of years after maintenance therapy) | |
5 years | $513,712.88 |
10 years | $67,203.94 |
20 years | Dominanta |
30 years | $5,232.11 |
Discount rate (base-case 3% for costs and utility) | |
0% | $5,830.11 |
5% | $10,230.91 |
7% | $14,374.62 |
ICER: incremental cost effectiveness ratio; AZA: azathioprine; MMF: mycophenolate mofetil; ESRD: end stage renal disease.
aMMF is less costly and more effective than AZA-based regimen.
bAssuming 100% probability of relapse during remission on either MMF or AZA after completing 3-year maintenance therapy.
cAssuming 1% or 2% per year increase in relapse during remission on either MMF or AZA after completing 3-year maintenance therapy.