Cost-Utility Analysis of Mycophenolate Mofetil versus Azathioprine Based Regimens for Maintenance Therapy of Proliferative Lupus Nephritis
Table 4
(a) Costs, effectiveness, and incremental cost effectiveness ratios (ICER) of the base-case and individual clinical trials in lifetime model (40 years). (b) Sensitivity analysis of lifetime model using Cochrane data.
Extrapolated treatment effect after 3-year maintenance therapy
Same as during treatment phase (base-case)
$6,454.24
No treatment effect from both MMF and AZA during extrapolated phase
$428,894.16
Treatment effect from both MMF and AZA decreases 1% per year
$15,096.38
Treatment effect from both MMF and AZA decreases 2% per year
$25,713.36
Time horizon (number of years after maintenance therapy)
5 years
$513,712.88
10 years
$67,203.94
20 years
Dominant
30 years
$5,232.11
Discount rate (base-case 3% for costs and utility)
0%
$5,830.11
5%
$10,230.91
7%
$14,374.62
ICER: incremental cost effectiveness ratio; AZA: azathioprine; MMF: mycophenolate mofetil; ESRD: end stage renal disease. MMF is less costly and more effective than AZA-based regimen. Assuming 100% probability of relapse during remission on either MMF or AZA after completing 3-year maintenance therapy. Assuming 1% or 2% per year increase in relapse during remission on either MMF or AZA after completing 3-year maintenance therapy.