Maxime Verhoeven

136 Chapter 7 Regarding productivity loss costs using the human capital approach, the highest costs over 5 years were observed in the TCZ+MTX strategy group: 51,700, vs. 39,900 (TCZ) and 46,500 (MTX), respectively. Using the friction cost approach for productivity loss costs differences between TCZ and MTX-based strategy groups were small. Direct healthcare costs were highest in the TCZ+MTX group and indirect non-healthcare costs were lowest in this group over 5 years. A similar number of QALYs was attained in all treatment groups over 5 years. Supplementary Table 4 gives an overview of undiscounted cost and QALYs. Figure 1 Cost (€ x 1,000) over time per initial treatment strategy in means. Outcomes based on single imputation nested in 10,000 bootstraps; costs expressed in euros. TCZ+MTX= initiation of tocilizumab + methotrexate strategy group; TCZ= initiation of tocilizumab + placebo- methotrexate strategy group; MTX= initiation of methotrexate + placebo-tocilizumab strategy group; other medication costs= all RA medication costs, including NSAID and csDMARDs, excluding bDMARDs; productivity loss costs= costs related to work loss or being less productive; direct healthcare costs= all costs related to healthcare, also for other diseases (RA medication costs excluded); indirect non healthcare costs= costs related to patient and family (e.g., travel cost; buying stair lift, etc.). Mean differences between the treatment strategies with 95% percentile ranges per cost category and QALYs are shown in Table 2. For TCZ+MTX, over 5 years, direct healthcare costs and medication costs as well as total cost are significantly (i.e., the 95% percentile range of the difference does not include 0) higher compared to those of MTX and indirect non-healthcare costs significantly lower. Productivity loss costs and QALYs are numerically higher without