Table 2.

Measurement values.

Treatment effectiveness: ACR20 responseORCODA samples (95% credible interval)
  Monotherapy1.00Mixed treatment
  Parallel combination1.721.11–2.51comparison
  Step-up combination1.550.46–2.51
  Step-down combination3.250.84–8.87
  Intensive step-up combination13.021.35–50.01
  Steroid plus monotherapy1.230.47–2.53
Treatment effectiveness: ACR50 responseORCODA samples (95% credible interval)
  Monotherapy1.00Mixed treatment
  Parallel combination2.501.14–4.80comparison
  Step-up combination1.390.16–5.30
  Step-down combination3.340.59–10.20
  Intensive step-up combination25.570.55–105.40
  Steroid plus monotherapy1.720.27–5.68
Treatment withdrawal6 month probabilityBeta distribution (n, p)
  Monotherapy0.09566,696Clinical trials
  Parallel combination0.0604,176
  Step-up combination0.02051,610
  Step-down combination0.0264,55
  Intensive step-up combination0.0495,173
  Steroid plus monotherapy0.07420,262
  ACR20 response: HAQ improvement37.8%(16)
  ACR50 response: HAQ improvement85.3%
  Annual HAQ progression rate0.0418(13)
Resource useHAQ group
  Annual cost of NHS resources (hospital days, hospital visits, and joint replacement)0 = £120.23
0–1 = £261.78
1–2 = £579.94
2–3 = £1,673.41
(35) Costed with 2007 PSSRU
6-month strategy costs
  Monotherapy£251.40BNF56 (September 2008)
  Parallel combination£263.56
  Step-up combination£266.93
  Step-down combination£269.29
  Intensive step-up combination£766.35
  Steroid plus monotherapy£269.98
Patient population characteristicsValueNormal distribution (SD)
  Age, yrs54.813.6(3)
  Women, %66.6
  Disease duration, yrs0.680.508
  Baseline HAQ1.110.7
  Lifetime cost of biologic therapy£57,919(13)
  Lifetime QALY of biologic therapy5.1514
  • ACR: American College of Rheumatology; CODA: Convergence Diagnostic and Output Analysis software; HAQ: Health Assessment Questionnaire; NHS: National Health Service (UK); PSSRU: Personal Social Services Research Unit; BNF: British National Formulary; QALY: quality-adjusted life-years.