Table 3: Economic analysis results.

Olara + DoxAIMMAIDGemDoc (Maki)PLDGemDoc (GeDDiS)Dox

Base-case results
Median PFSa (months)6.56.06.03.93.92.83.9
Median OSa (months)24.014.314.311.511.512.011.5
10-year survival (%)9.54.74.75.05.02.95.0
Mean LYs (95% CrI)3.37 (2.53–4.36)2.17 (1.24–3.44)2.17 (1.26–3.35)2.10 (1.55–2.96)2.10 (1.53–2.98)1.69 (0.91–2.85)2.10 (1.55–2.94)
Mean total expected lifetime cost ($) (per patient (95% CrI))182,984 (157,673–207,429)122,166 (106,753–138,696)104,787 (90,428–119,603)83,473 (69,478–99,681)53,925 (44,335–65,606)50,976 (43,686–59,751)49,330 (43,058–58,480)
Incremental cost ($) (per LYb)
Each comparator versus Dox105,4081,064,437810,457DominatedDominatedDominatedReference
Fully incremental, each comparator versus previous nondominated alternative105,408DominatedExtendedly dominatedDominatedDominatedDominatedNA
Pairwise, Olara + Dox versus each comparator (per LY)50,70165,18978,480101,78478,679105,408
Secondary analysis
Mean QALYs per patient (95% CrI)1.86 (1.40–2.42)1.21 (0.73–1.89)1.21 (0.74–1.83)1.17 (0.88–1.63)1.17 (0.87–1.64)0.94 (0.54–1.57)1.17 (0.87–1.61)
Incremental cost ($) (per QALY)
Each comparator versus Dox196,3091,841,1571,642,925DominatedDominatedDominatedReference
Fully incremental, each comparator versus previous nondominated alternative196,309Extendedly dominatedExtendedly dominatedDominatedDominatedDominatedNA
Pairwise, Olara + Dox versus each comparator (per QALY)94,839120,846145,447189,147143,732196,309

AIM = ifosfamide + doxorubicin + mesna; CrI = credible interval (within which 95% of probabilistic simulations were observed); Dox = doxorubicin; GemDoc = gemcitabine + docetaxel; ICER = incremental cost-effectiveness ratio; LY = life-year; MAID = mesna + doxorubicin + ifosfamide + dacarbazine; NA = not applicable; Olara + Dox = olaratumab + doxorubicin; OS = overall survival; PFS = progression-free survival; PLD = pegylated liposomal doxorubicin; QALY = quality-adjusted life year. Cost and outcomes (with the exception of median PFS, OS and 10-year survival) are discounted at 3%. aCalculated from the survival functions used in the model. bDominated: a dominated intervention is defined as an intervention with higher costs and worse outcomes than an alternative intervention. Extendedly dominated: in a fully incremental analysis, a treatment is said to be extendedly dominated when the treatment’s ICER is higher than the ICER of the next, more effective, alternative (i.e., the given treatment is dominated by the combination of two alternatives and should not be used to calculate appropriate ICERs). For example, consider that there are three drug regimens, A, B, and C, with regimen C being more effective (resulting in greater LYs) and more costly than regimen B and regimen B being more effective (resulting in greater LYs) and more costly than regimen A. Drug regimen C is said to extendedly dominate drug regimen B if the ICER for drug regimen C when compared with drug regimen A is more favorable (has a lower value) than the ICER for drug regimen B when compared with drug regimen A.