Table 2. QALY and ICER for Single-Joint Contracture From Societal Perspective.
| Joint type and severity | Treatment combinationa | Mean (SD) | ICER (MCSE), $/QALYb | |
|---|---|---|---|---|
| Total cost, $ | Lifetime QALYs | |||
| MCP joint | ||||
| Low severity | PNA-PNA-PNA | 3339 (544) | 15.09 (4.95) | Reference case |
| PNA-PNA-LF | 9448 (4003) | 15.12 (4.97) | 212 647 (36 000) | |
| LF-LF-LF | 25 419 (6785) | 15.17 (4.98) | 293 592 (48 000) | |
| High severity | PNA-PNA-PNA | 3512 (462) | 14.64 (4.80) | Reference case |
| PNA-PNA-LF | 11 225 (3653) | 14.72 (4.83) | 93 932 (16 500) | |
| LF-LF-LF | 26 527 (6879) | 14.88 (4.87) | 98 624 (26 333) | |
| PIP joint | ||||
| Low severity | PNA-PNA-PNA | 3567 (399) | 15.03 (4.95) | Reference case |
| PNA-PNA-LF | 11 789 (3217) | 15.06 (4.95) | 263 726 (29 000) | |
| LF-LF-LF | 27 940 (6465) | 15.12 (4.97) | 263 427 (64 000) | |
| High severity | PNA-PNA-PNA | 3640 (338) | 14.59 (4.80) | Reference case |
| PNA-PNA-LF | 12 574 (2649) | 14.62 (4.81) | 421 843 (24 000) | |
| LF-LF-LF | 31 472 (5307) | 14.66 (4.82) | 408 244 (25 500) | |
Abbreviations: CCH, collagenase clostridium histolyticum; ICER, incremental cost-effectiveness ratio; LF, limited fasciectomy; MCP, metacarpophalangeal; MCSE, Monte Carlo standard error; PNA, percutaneous needle aponeurotomy; QALY, quality-adjusted life-year.
A total of 27 treatment sequences were modeled, as follows: (1) CCH-PNA-LF, (2) CCH-LF-PNA, (3) PNA-CCH-LF, (4) PNA-LF-CCH, (5) LF-CCH- PNA, (6) LF-PNA-CCH, (7) CCH-CCH-PNA, (8) CCH-CCH-LF, (9) CCH-PNA-CCH, (10) CCH-LF-CCH, (11) PNA-PNA-LF, (12) PNA-PNA-CCH, (13) PNA-CCH-PNA, (14) PNA-LF-PNA, (15) LF-LF-CCH, (16) LF-LF-PNA, (17) LF-CCH-LF, (18) LF-PNA-LF, (19) PNA-CCH-CCH, (20) LF-CCH-CCH, (21) CCH-PNA-PNA, (22) LF-PNA-PNA, (23) CCH-LF-LF, (24) PNA-LF-LF, (25) CCH-CCH-CCH, (26) PNA-PNA-PNA, and (27) LF-LF-LF.
ICER compared with next best treatment combination with highest net monetary benefit.