Table 2.
One-way and full sensitivity analyses performed as part of the cost-effectiveness evaluation
| Component | Base case | Variation in sensitivity analysis |
|---|---|---|
| One-way sensitivity analysis | ||
| Proportion of chronic dysphagia | 50% chronic, 50% resolved within 5 years |
Scenario 1: 0% chronic, 100% resolved within 5y Scenario 2: 100% chronic, 0% resolved within 5y |
| Cost of proton therapy (33 fx) | $36,659 |
Scenario 1: $31,659 Scenario 2: $26,659 Scenario 3: $21,659 |
| Full sensitivity analysis | ||
| QALY calculation | ||
| Hazard ratio for patients with > 10 pack-year smoking history | 1.73 | Normal distribution matching 95% CI 1.17–2.57 |
| Quality-adjustment factors | Beta distributions matching 95% CIs: | |
| Dysphagia (grade ≥ 2) | 0.83 | 0.70–0.93 |
| Esophagitis (grade ≥ 3) | 0.66 | 0.35–0.90 |
| Xerostomia (grade ≥ 2) | 0.82 | 0.72–0.90 |
| Hypothyroidism (elevated TSH with or without T4/T3 changes requiring hormone replacement) | 0.97 | 0.94–0.98 |
| Oral mucositis (grade ≥ 3) | 0.06 | 0.01–0.15 |
| Cost-effectiveness calculation | ||
| Proportion of oral mucositis or esophagitis cases requiring inpatient hospital admission | 10% | Normal distribution matching 95% CI 0–20% |
| Proportion of oral mucositis cases resulting in emergency room visit | 15% | Normal distribution matching 95% CI 5–25% |
| Proportion of esophagitis cases resulting in emergency room visit | 10% | Normal distribution matching 95% CI 0–20% |
| Proportion of dysphagia cases requiring chronic PEG tube | 10% | Normal distribution matching 95% CI 0–20% |
| Proportion of patients receiving stricture dilation for dysphagia | 16% | Normal distribution matching 95% CI 11–21% |
| Cost of stricture dilation | $1700 | Normal distribution matching 95% CI $1200–$2200 |
More information about the components used in the quality-adjusted life years calculation can be found in ref [12]