Additional Details on the CADTH Reanalyses and Sensitivity Analyses of the Economic Evaluation

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Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Jun.

Cover of Pharmacoeconomic Report: Satralizumab (Enspryng)

Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet].

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Appendix 4Additional Details on the CADTH Reanalyses and Sensitivity Analyses of the Economic Evaluation

Table 16Disaggregated Summary of CADTH’s Economic Evaluation Results for Satralizumab Indicated as Monotherapy

Treatment	Component	Value	Incremental (versus reference)
Discounted QALYs
No treatment	EDSS 0	0.00
	EDSS 1	0.20
	EDSS 2	0.37
	EDSS 3	1.31
	EDSS 4	1.44
	EDSS 5	0.67
	EDSS 6	0.90
	EDSS 7	0.37
	EDSS 8	−0.56
	EDSS 9	−0.97
	Total	3.69
Satralizumab	EDSS 0	0.00	0.00
	EDSS 1	0.43	0.24
	EDSS 2	0.78	0.41
	EDSS 3	2.39	1.09
	EDSS 4	2.29	0.85
	EDSS 5	0.92	0.25
	EDSS 6	1.27	0.36
	EDSS 7	0.41	0.04
	EDSS 8	−0.39	0.17
	EDSS 9	−0.56	0.41
	Total	7.51	3.82
Discounted costs ($)
No treatment	Acquisition	0
	Administration	0
	Adverse events management	56,697
	Relapse management (moderate or mild)	15,133
	Relapse management (severe)	15,486
	Supportive care	737,561
	Total	824,877
Satralizumab	Acquisition	1,448,057	1,448,057
	Administration	205	205
	Adverse events management	34,323	−22,374
	Relapse management (moderate or mild)	12,432	−2,701
	Relapse management (severe)	13,512	−1,974
	Supportive care	604,325	−133,236
	Total	2,112,853	1,287,976
ICER ($/QALY) versus reference
No treatment		Reference
Satralizumab		337,535 versus no treatment

: EDSS = Expanded Disability Status Scale; ICER = incremental cost-effectiveness ratio; QALY = quality-adjusted life-year.

Table 17Disaggregated Summary of CADTH’s Economic Evaluation Results for Satralizumab Indicated as Combination Therapy

Treatment	Component	Value	Incremental (versus reference)
Discounted QALYs
IST	EDSS 0	0.00
	EDSS 1	0.09
	EDSS 2	0.23
	EDSS 3	1.94
	EDSS 4	1.54
	EDSS 5	0.57
	EDSS 6	1.00
	EDSS 7	2.56
	EDSS 8	−0.12
	EDSS 9	−0.67
	Total	7.12
Satralizumab + IST	EDSS 0	0.00	0.00
	EDSS 1	0.15	0.06
	EDSS 2	0.42	0.19
	EDSS 3	2.90	0.96
	EDSS 4	2.17	0.63
	EDSS 5	0.70	0.13
	EDSS 6	1.34	0.34
	EDSS 7	2.30	−0.26
	EDSS 8	−0.08	0.04
	EDSS 9	−0.40	0.27
	Total	9.47	2.35
Discounted costs ($)
IST	Acquisition	0
	Administration	0
	Immunosuppressive therapy	7,327
	Adverse events	94,107
	Relapse management (moderate or mild)	15,619
	Relapse management (severe)	9,956
	Supportive care	584,483
	Total	711,493
Satralizumab + IST	Acquisition	1,873,525	1,873,525
	Administration	223	223
	Immunosuppressive therapy	7,571	7,327
	Adverse events	62,358	94,107
	Relapse management (moderate or mild)	13,011	15,619
	Relapse management (severe)	8,540	9,956
	Supportive care	515,803	584,483
	Total	2,481,030	711,493
ICER versus reference
IST versus no treatment		Reference
Satralizumab + IST		$752,179 versus IST

: EDSS = Expanded Disability Status Scale; ICER = incremental cost-effectiveness ratio; IST = immunosuppressive therapy; QALY = quality-adjusted life-year.

Detailed Results of CADTH Base Case

Scenario Analyses

Table 18Scenario Analyses for Satralizumab Indicated as Monotherapy Versus No Treatment

Scenario analysis	Drug	Total costs ($)	Total LYs	Total QALYs	ICER ($/QALY)
Relapse recovery	No treatment	412,905	26.29	17.05	Reference
Relapse recovery	Satralizumab	1,827,373	26.70	18.87	775,037
Societal perspective	No treatment	3,348,905	21.74	1.95	Reference
Societal perspective	Satralizumab	4,609,840	22.89	6.19	297,778

: ICER = incremental cost-effectiveness ratio; LY = life-year; QALY = quality-adjusted life-year.

Table 19Scenario Analyses for Satralizumab in Combination With IST Versus IST Alone

Scenario analysis	Drug	Total costs ($)	Total LYs	Total QALYs	ICER ($/QALY)
Relapse recovery	IST	464,286	26.13	16.33	Reference
Relapse recovery	Satralizumab + IST	2,397,117	26.47	17.77	1,342,991
Societal perspective	IST	3,375,119	21.74	5.81	Reference
Societal perspective	Satralizumab + IST	5,116,552	22.89	8.34	687,246
Assumed differences in rate of adverse events between groups	IST	981,284	22.68	7.12	Reference
	Satralizumab + IST	2,457,032	23.41	9.37	657,419

: ICER = incremental cost-effectiveness ratio; IST = immunosuppressive therapy; LY = life-year; QALY = quality-adjusted life-year.

Table 20Scenario Analysis in Consideration of Each Subgroup — 90% Combination Therapy; 10% Monotherapy

Scenario analysis	Drug	Total costs ($)	Total QALYs	ICER ($/QALY)
90% of results based on combination therapy and 10% of results based on monotherapy	Mixed comparator (no treatment or IST)	813,539	4.03	Reference
	Satralizumab ± IST	2,149,671	7.71	363,771

: ICER = incremental cost-effectiveness ratio; IST = immunosuppressive therapy; QALY = quality-adjusted life-year.

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Pharmacoeconomic Report: Satralizumab (Enspryng): (Hoffmann-La Roche Limited): Indication: Neuromyelitis optica spectrum disorder [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2021 Jun. Appendix 4, Additional Details on the CADTH Reanalyses and Sensitivity Analyses of the Economic Evaluation.
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