A systematic review and economic model of the effectiveness and ...

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Review of economic evaluations of ADHD drug interventions in children and adolescents
TABLE 67 Response rates and discontinuation rates used in the cost–utility model submitted by Janssen-Cilag
Treatment Response rate Discontinuation rate
BT
IR-MPH
Concerta XL
ATX [Confidential information removed]
Equasym XL
Combination treatment
DEX
TABLE 68 Proportions of patients switching to alternative second-line therapies in cost–utility model submitted by Janssen-Cilag
were based on CON-CAN-1 90 for Concerta XL
and IR-MPH.
[Confidential information removed].
The response rates and discontinuation rates used
in the submission are shown in Table 67.
The proportions of patients switching to BT,
combination treatment or DEX as second-line
therapy were based on a previously published
study that used expert opinion. 129 These
proportions are shown in Table 68.
Summary of resource utilisation and
cost data
The resource use associated with managing ADHD
patients on BT, pharmacotherapy and
Switch from
Switch to 1st line BT (%) 1st line pharmacotherapy (%)
IR-MPH 57.92 NA
Combination treatment 42.08 37.42
BT NA 17.35
DEX NA 45.24
NA, not applicable.
TABLE 69 Annual treatment, follow-up and monitoring costs used in cost–utility model submitted by Janssen-Cilag
Item Behavioural therapy (£) Drug treatment (£) Combination treatment (£)
Programme cost
Consultations:
1033 Varies 1033 + drug cost
Responders 333 737 737
Non-responders 808 1012 1012
Co-morbidities 652 349 349
Tests:
Responders 5.3 0.5 0.5
Non-responders 43 79.6 80
Co-morbidities 6.0 4.9 4.9
combination treatment was based on an update of
a previously published study that used expert
opinion. 129 Resource use quantities were estimated
separately for responders and non-responders and
for the presence of co-morbidities. The panel
estimated the annual costs of each programme,
including the cost of the BT, the cost of follow-up
consultations and the cost of monitoring tests, and
these were divided into monthly figures for the
purpose of the model. In order to do this, annual
costs were divided by 12, with the exception of the
treatment cost of BT. This was assumed to take
place over a period of 8.63 weeks, and so the cost
of this was divided by 8.63 and multiplied by
4 weeks (assuming 4 weeks = 1 month), and was
only applied in the first 2 months in the model.
Table 69 shows the relevant annual costs for each
strategy.