Table 2

Results of base-case and additional cost-effectiveness analyses comparing COBRA Classic and COBRA Avant-Garde to COBRA Slim in high-risk patients and COBRA Slim to TSU on low-risk patients (the last strategy being the comparator/reference scheme in every case)

               High-risk         Low-risk
COBRA Classic n=98COBRA Avant-Garde n=93COBRA Slim n=98COBRA Slim n=43TSU n=47
Base case: QALY as outcomeMean (95% CI)Mean (95% CI)Mean (95% CI)Base case: QALY as outcomeMean (95% CI)Mean (95% CI)
 Total costs, k€ 6.086 (4.710 to 7.462) 5.257 (3.909 to 6.605) 4.622 (3.649 to 5.594) Total costs, k€4.007 (2.631 to 5.383)4.624 (2.685 to 6.562)
 QALYs 1.551 (1.491 to 1.611) 1.544 (1.473 to 1.615) 1.553 (1.494 to 1.612) QALYs1.629 (1.569 to 1.688)1.488 (1.394 to 1.581)
 ∆ Costs vs Slim, k€ 1.464 (−0.198 to 3.127) 0.636 (−0.987 to 2.258)  Reference ∆ Costs vs TSU, k€−0.617 (−2.799 to 1.566)  Reference
 ∆ QALYs vs Slim −0.002 (−0.086 to 0.082) −0.009 (−0.102 to 0.084) ∆ QALYs vs TSU0.141 (0.008 to 0.274)
 ICER (k€ per QALY) Dominated Dominated ICER (k€ per QALY)Dominant
Sustained remission as outcomeSustained remission as outcome
 SR (w16-104), % 29 (20 to 38) 32 (22 to 42) 30 (21 to 39) SR (w16-104), %42 (33 to 52)26 (13 to 38)
 ∆ SR vs Slim, % −1 (−14 to 12) 2 (−12 to 16)  Reference ∆ SR vs TSU, %17 (−3 to 37)  Reference
 ICER (k€ per %SR) Dominated 36.191 ICER (k€ per %SR)Dominant
bDMARDs priced to biosimilarbDMARDs priced to biosimilar
 Total costs, k€ 5.510 (4.347 to 6.673) 4.851 (3.734 to 5.968) 4.340 (3.421 to 5.258) Total costs, k€3.851 (2.688 to 5.014)3.856 (2.479 to 5.232)
 ∆ Costs vs Slim, k€ 1.170 (−0.285 to 2.625) 0.511 (−0.904 to 1.926)  Reference ∆ Costs vs TSU, k€−0.004 (−1.718 to 1.709)  Reference
 ICER (k€ per QALY) Dominated Dominated ICER (k€ per QALY)Dominant
 ICER (k€ per %SR) Dominated 29.113 ICER (k€ per %SR) Dominant
  • Data are expressed as bootstrapped mean and 95% CIs of costs and benefits from all 25 000 replications from each of the 15 multiply imputed datasets.

  • bDMARDs, biological disease-modifying antirheumatic drugs; ICER, incremental cost-effectiveness ratio, either for cost per QALY or cost per per cent sustained remission; k€, thousand euros; QALY, quality-adjusted life years, time-weighted as area under the curve for the 2-year trial; SR, sustained remission measured with Disease Activity Score in 28 joints with C reactive protein <2.6 from week 16 onwards until week 104 and at every timepoint in between; TSU, Tight-Step-Up.