Given issues with the stability of the sponsor’s probabilistic analysis (i.e., wide variation in the incremental cost-effectiveness ratios [ICERs] at each model run due in part to the wide credible intervals within the sponsor’s submitted network meta-analysis [NMA]), CADTH conducted reanalyses deterministically for both the anti–tumour necrosis factor (TNF) alpha naive populations and anti–TNF alpha exposed populations as distinct populations. CADTH also accounted for limitations by including relevant comparators, revising the probability of surgery and of post-surgery complications, adjusting costs and resource use, and switching off dose escalation and the loss and regaining of response.
In the anti–TNF alpha naive population, subcutaneous (SC) vedolizumab was dominated by tofacitinib (i.e., tofacitinib was associated with more quality-adjusted life-years [QALYs] at a lower cost compared with vedolizumab SC). In the anti–TNF alpha exposed population, vedolizumab SC was found to be the optimal therapy at a willingness to pay (WTP) above $1,152,959 per QALY gained when compared with tofacitinib. Between a WTP threshold of $117,761 to $1,152,959 per QALY gained, tofacitinib would be the optimal therapy, while below a WTP threshold $117,761 per QALY gained, conventional therapy would be the optimal therapy.
Version: Final (with redactions)
Funding: CADTH receives funding from Canada’s federal, provincial, and territorial governments, with the exception of Quebec.
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