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|
Variable
|
Base case
|
Range for sensitivity analysis
|
Distribution for probabilistic sensitivity analysis
|
Reference
|
|---|
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Probabilities
| | | | |
|
Annual probability of recurrence post abdominoperineal resection
|
0.0871
|
0.0435–0.130a
|
Beta
|
Rutkowski et al. [8]
|
|
Annual conditional probability of local recurrence post abdominoperineal resectiona
|
0.135
|
0.0675–0.203a
|
Uniform
|
Rutkowski et al. [8]
|
|
Annual probability of 1st progression in metastatic GIST
|
0.370
|
0.296–0.444b
|
Beta
|
Blanke et al. [4]
|
|
Annual probability of 2nd progression in metastatic GIST
|
0.811
|
0.649–0.973b
|
Beta
|
Blanke et al. [4]
|
|
Annual probability of 3rd progression in metastatic GIST
|
0.708
|
0.566–0.850b
|
Beta
|
Demetri et al. [13]
|
|
Annual probability of death in metastatic GIST post-regorafenib
|
0.405
|
0.270–0.410b
|
Beta
|
Demetri et al. [14]
|
|
Utilities
| | | | |
|
Recurrence-free health state post abdominoperineal resection
|
0.830
|
0.650–1
|
Beta
|
Miller et al. [7]
|
|
Recurrence-free health state on continued imatinib until progression
|
0.935
|
0.750–1b
|
Beta
|
Wilson et al. [17]
|
|
GIST recurrence
|
0.748
|
0.598–0.898b
|
Beta
|
Majer et al. [10]
|
|
GIST 1st progression in metastatic disease
|
0.712
|
0.685–0.739
|
Beta
|
Chabot et al. [18]
|
|
GIST 2nd progression in metastatic disease
|
0.712
|
0.685–0.739
|
Beta
|
Assumption
|
|
GIST 3rd progression in metastatic disease
|
0.712
|
0.685–0.739
|
Beta
|
Assumption
|
|
COSTS (SGD)
|
|
Annual cost of imatinib 400 mg once daily
|
37 040
|
7 408–44 448c
|
Gamma
|
NCCS data
|
|
Annual cost of sunitinib 50 mg once daily 4 weeks on, 2 weeks off
|
64 063
|
51 250–76 876b
|
Gamma
|
NCCS data
|
|
Annual cost of regorafenib 160 mg once daily 3 weeks on, 1 week off
|
72 001
|
57 601–86 401b
|
Gamma
|
NCCS data
|
|
Abdominoperineal resection
|
38 000
|
30 400 –45 600b
|
Gamma
|
NCCS data
|
|
Salvage surgery (following 1st local recurrence post abdominoperineal resection)
|
38 000
|
30 400–45 600b
|
Gamma
|
NCCS data
|
|
Annual cost of follow-up (consultation, blood tests, computer tomography scans every 3 months)
|
3 000
|
2 400–3 600b
|
Gamma
|
NCCS data
|
- mg milligrams, GIST gastrointestinal stromal tumor, NCCS National Cancer Centre Singapore, SGD Singapore dollars
- a ± 50% (wider intervals used in estimation due to paucity of systematic data for recurrences specifically in rectal GIST post neoadjuvant imatinib)
- b ± 20%
- c + 20% and −80% (lower bound for imatinib extended to −80% to account for possible significant decrease in imatinib cost with advent of generic imatinib)