Mean (2.5–97.5 percentile) difference in costs (€, rounded to the nearest hundreds) and QALY, and ICER with distribution in cost-effectiveness plane (%).
| TCZ + MTX vs MTX | TCZ vs MTX | |
|---|---|---|
| Over 2 years | ||
| Medication costs | 14,800 (12,000 to 17,600) | 15,900 (13,100 to 18,600) |
| Direct healthcare costs | 8700 (4100 to 13,400) | –1400 (–4700 to 1800) |
| Indirect nonhealthcare costs | –600 (–1200 to 0) | 200 (–700 to 1100) |
| Productivity loss costs# | 2500 (–4200 to 9300) | –3200 (–9900 to 3400) |
| Productivity loss costs$ | 400 (–1100 to 1900) | –300 (–1900 to 1200) |
| Total cost and effect | ||
| Healthcare perspective† | 23,500 (18,000 to 29,000) | 14,500 (10,000–18,900) |
| Societal perspective# | 25,300 (17,200 to 33,300) | 11,400 (3600–19,300) |
| Societal perspective$ | 23,200 (17,800 to 28,600) | 14,400 (9600–19,000) |
| QALY | 0.06 (–0.02 to 0.13) | 0.03 (–0.05 to 0.11) |
| ICERHC | 425,088 | 539,531 |
| % (SE, SW, NW NE) | 0, 0, 7, 93 | (0, 0, 26, 74) |
| ICER# | 458,954 | 425,144 |
| % (SE, SW, NW NE) | 0, 0, 7, 93 | (0, 0, 26, 74) |
| ICER$ | 420,829 | 533,521 |
| % (SE, SW, NW NE) | 0, 0, 7, 93 | (0, 0, 26, 74) |
| Over 5 years | ||
| Medication costs | 14,600 (9300 to 19,900) | 17,200 (11,700–22,500) |
| Direct healthcare costs | 19,900 (9700 to 30,300) | –2,700 (–9700 to 3800) |
| Indirect nonhealthcare costs | –4,100 (–5400 to –2800) | –2,800 (–4300 to –1400) |
| Productivity loss costs# | 5200 (–8400 to 18,700) | –6,600 (–19,900 to 6800) |
| Productivity loss costs$ | 1500 (–1900 to 4200) | 0 (–3300 to 2900) |
| Total cost and effect | ||
| Healthcare perspective | 34,500 (22,200 to 46,600) | 14,500 (5100 to 23,500) |
| Societal perspective# | 35,600 (18,700 to 52,200) | 5,000 (–10,500 to 20,800) |
| Societal perspective$ | 31,600 (19,600 to 43,600) | 11,500 (1700–20,900) |
| QALYs | 0.06 (–0.10 to 0.22) | –0.03 (–0.20 to 0.1) |
| ICERHC | 575,982 | –426,967 |
| % (SE, SW, NW NE) | (0, 0, 23, 77) | (0, 0, 65, 35) |
| ICER# | 594,021 | –149,241 |
| % (SE, SW, NW NE) | (0, 0, 23, 77) | (8, 18, 47, 27) |
| ICER$ | 526,674 | –337,609 |
| % (SE, SW, NW NE) | (0, 0, 23, 77) | (1, 0, 65, 34) |
Outcomes based on single imputation nested in 10,000 bootstraps; costs expressed in euros. TCZ + MTX: initiation of TCZ + MTX strategy group; TCZ: initiation of TCZ + placebo-MTX strategy group; MTX: initiation of MTX + placebo-TCZ strategy group. Medication costs: all RA medication costs; direct healthcare costs: all costs related to healthcare (also for other diseases; RA medication costs excluded); indirect nonhealthcare costs: costs related to patient and family (e.g., travel costs, buying stair lift); productivity loss costs: costs related to work loss or being less productive.
↵†Healthcare perspective: direct healthcare cost + medication cost; societal perspective: direct healthcare costs + indirect nonhealthcare costs + productivity loss costs + medication costs.
↵#Using human capital approach.
↵$Using friction cost approach, only counting costs for a period of absence up to 85 days. HC: healthcare perspective; ICER: incremental cost-effectiveness ratio (using societal perspective according to human capital approach); MTX: methotrexate; QALY: quality-adjusted life-years; TCZ: tocilizumab; SE: south-east (gain in QALY, less expensive; i.e., TCZ dominant); SW: southwest (loss in QALY, less expensive); NW: northwest (loss in QALY, more expensive; i.e., TCZ inferior); NE: northeast (gain in QALY, more expensive).