Table 6 Model results: sensitivity analyses
Sensitivity analyses | Incremental costs | Incremental QALY | ICER (€ per QALY gained) |
|---|---|---|---|
Base case | −€393 | 0.029 | Dominant |
Time horizon | |||
1 year | −€152 | 0.010 | Dominant |
5 years | −€562 | 0.043 | Dominant |
10 years | −€752 | 0.071 | Dominant |
Lifetime (25 years) | −€774 | 0.091 | Dominant |
Discount rate for costs and benefits | |||
0% | −€405 | 0.029 | Dominant |
5% | −€388 | 0.027 | Dominant |
Patient population and utility estimation | |||
Base case population with utilities estimated from the GALAXY utility algorithm | −€393 | 0.010 | Dominant |
Use ITT study population with utilities estimated from the GALAXY utility algorithm | −€396 | 0.009 | Dominant |
Use ITT study population with utilities estimated from the GALAXY utility algorithm with life time horizon | −€781 | 0.052 | Dominant |
Treatment effect | |||
Analysis with equal FEV1 treatment effect (128 mL) across UMEC/VI and TIO/OLO arms after initiating therapy | −€338 | 0.000 | Equally effective, less expensive |
Incremental FEV1 treatment effect with UMEC/VI after initiating therapy equal to the upper 95% CI (+ 77 mL) | −€420 | 0.041 | Dominant |
Incremental FEV1 treatment effect with UMEC/VI after initiating therapy equal to the lower 95% CI (+ 28 mL) | −€362 | 0.012 | Dominant |
Treatment discontinuation | |||
Treatment discontinuation rates from first year sourced from population-based, retrospective, observational study in Catalonia (50%) and from the UPLIFT trial for subsequent years (8.7%) | −€252 | 0.018 | Dominant |
Subsequent treatment | |||
Patients on UMEC/VI escalate to UMEC/VI and FP 500 mcg, two inhalations per day while patients on TIO/OLO escalate to SAL/FP 500/50 mcg, two inhalations per day + TIO 18 mcg, one inhalation per day | −€355 | 0.032 | Dominant |
Costing | |||
Cost of level of dyspnea plus 20% | −€397 | 0.029 | Dominant |
Cost of level of dyspnea minus 20% | −€392 | 0.029 | Dominant |
Cost of exacerbations plus 20% | −€404 | 0.029 | Dominant |
Cost of exacerbations minus 20% | −€385 | 0.029 | Dominant |