Table 2

Overview of the scenario analyses

ScenarioDescriptionDetails
Base case5-year time horizon from societal perspective
16-month time horizon from societal perspectiveThe follow-up period of the SELECT-D trial was 6 months; therefore, outcomes beyond 6 months had to be extrapolated based on other publications.
2Base case analysis from healthcare payer’s perspectiveIn the Netherlands, guidelines advise to calculate the ICER from a societal perspective, while in countries such as the UK or Belgium, the healthcare payer’s perspective is preferred. To make results comparable with other countries, we also calculated the base case ICER from a healthcare payer’s perspective, by excluding the indirect costs.
3Base case analysis with dalteparin dose of 12 500 IUThe costs of dalteparin vary with the patient’s weight. For the base case analysis, we assumed an average weight between 69 and 82 kg. In scenarios 3 and 4, we calculated the base case ICER with the costs of dalteparin based on weight categories of 57–68 kg (12 500 IE daily during month 1 followed by 10 000 IE daily in months 2–6) and 83–98 kg (18 000 IE daily during month one followed by 15 000 IE daily in months 2–6), respectively.
4Base case analysis with dalteparin dose of 18 000 IU
5Scenario one with treatment duration based on Streiff et al17This scenario was similar to scenario 1, except for the treatment period which was based on a study of Streiff et al, who—comparable to SELECT-D—compared rivaroxaban to LMWH for the prevention of recurrent VTE in cancer patients.17 They found an average treatment duration of 1 and 3 months for LMWH and rivaroxaban, respectively.
6Base case analysis using drug-specific distributions for the types of VTE and MBDue to low numbers of VTE and MB events observed in the SELECT-D trial15 and HOKUSAI VTE Cancer trials, respectively, we calculated the distribution of the types of VTE and MB in the base case analysis based on the total number of events and assumed it to be equal for both drugs. In this scenario, we assess the effect of this assumption on the cost-effectiveness results by using the drug-specific distributions of the types of VTE and MB based on the results of the SELECT-D and HOKUSAI VTE Cancer trials.15 16
  • HOKUSAI VTE, Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism; ICER, incremental cost-effectiveness ratio; IU, international units; LMWH, low molecular weight heparin; MB, major bleeding; SELECT-D, Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial; VTE, venous thromboembolism.