Table 2.
Mean Incremental Cost and Effectiveness of Six-Food Elimination Diet and Topical Fluticasone per Cohort Member in the Base Case Scenario and Sensitivity Analyses as Mean per Individual Cohort Member over 10,000 Probabilistic Sensitivity Analysis Iterations per Scenario.
| Strategy | Cost (2015 USD)* |
Incremental Cost |
Effectiveness (QALYs)* |
Incremental Effectiveness |
Incremental Cost Effectiveness Ratio† |
|---|---|---|---|---|---|
| Base case scenario with crossover for histologic failure of first treatment | |||||
| SFED rescue fluticasone | $5,720 | 4.29 | |||
| SFED rescue budesonide | $7,276 | $1,557 | 4.26 | −0.03 | −$49,861 |
| Fluticasone rescue SFED | $9,262 | $3,542 | 4.24 | −0.05 | −$71,522 |
| Budesonide rescue SFED | $21,609 | $15,889 | 4.17 | −0.12 | −$137,826 |
| Sensitivity analysis without 50% dose reduction in steroid remission | |||||
| SFED rescue fluticasone | $7,422 | 4.29 | |||
| SFED rescue budesonide | $9,055 | $1,633 | 4.26 | −0.03 | −$52,325 |
| Fluticasone rescue SFED | $15,334 | $7,912 | 4.24 | −0.05 | −$159,772 |
| Budesonide rescue SFED | $38,071 | $30,649 | 4.17 | −0.12 | −$265,858 |
| Sensitivity analysis without crossover to alternate treatment | |||||
| SFED | $3,392 | 4.29 | |||
| Fluticasone | $7,279 | $3,888 | 4.26 | −0.03 | −$127,403 |
| Budesonide | $22,057 | $18,666 | 4.27 | −0.02 | −$954,173 |
| Sensitivity analysis without crossover to alternate treatment or dilation | |||||
| SFED rescue fluticasone | $2,178.00 | 4.18 | |||
| Fluticasone rescue SFED | $5,108.00 | $2,930.00 | 4.20 | 0.02 | $171,597 |
| Budesonide rescue SFED | $17,969.00 | $15,791.00 | 4.21 | 0.03 | $515,291 |
| Sensitivity analysis among patients 17 years of age or under† | |||||
| SFED rescue fluticasone | $4,615 | 4.29 | |||
| Fluticasone rescue SFED | $5,531 | $916 | 4.26 | −0.03 | −$27,031 |
| SFED rescue budesonide | $5,830 | $1,215 | 4.27 | −0.03 | −$46,417 |
| Budesonide rescue SFED | $11,511 | $6,897 | 4.2 | −0.09 | −$75,347 |
| Sensitivity analysis among patients over 17 years of age | |||||
| SFED rescue fluticasone | $5,944 | 4.29 | |||
| SFED rescue budesonide | $7,505 | $1,562 | 4.26 | −0.03 | −$47,347 |
| Fluticasone rescue SFED | $10,091 | $4,148 | 4.23 | −0.05 | −$76,736 |
| Budesonide rescue SFED | $24,775 | $18,832 | 4.17 | −0.12 | −$155,742 |
USD, United States Dollars; QALYs, quality adjusted life years.
*
Per person per five-year horizon discounted at 3% per year after the first.
†
The incremental cost effectiveness ratio should be interpreted with caution in the setting of near-equal utility.