Table 3.

Results of sensitivity analysis

VariablePD at stage IIIPD at stage IVPD at cancer
CostQALYICERCostQALYICERCostQALYICER
Polyposis distribution and progression
    Stage distribution at age 30 (% stage 0/I/II/III/IV/cancer)
        100/0/0/0/0/014,00020.20Dominated10,30020.266,4009,70020.17Reference
        60/18/10/10/2/026,80019.96Dominated19,70020.0870019,40019.59Reference
    Transition probabilities
        Stages 0 to IV
            50% × BC9,80020.26Dominated7,20020.303,9002,00020.26Reference
            200% × BC32,80019.85Dominated27,40019.921,00026,80019.27Reference
        Stages IV to cancer
            50% × BC17,90020.14Dominated13,00020.2325,30011,20020.16Reference
            200% × BC18,00020.12Dominated13,30020.18Reference14,10019.88Dominated
PD characteristics
    Eligible for curative surgery (%)
        2517,90020.13Dominated13,00020.205,50011,70019.97Reference
        7517,90020.14Dominated13,10020.211,80012.80020.06Reference
    Perioperative mortality (%)
        018,20020.26Dominated13,20020.273,00012,50020.04Reference
        1017,60020.01Dominated12,90020.153,60012,50020.03Reference
Cancer mortality
    Age related
        1 × U.S. life table19,10020.90Dominated14,10020.982,60013,50020.77Reference
        2.1 × U.S. life table17,00019.57Dominated12,40019.643,70011,70019.48Reference
    Post-curative surgery
        50% × BC17,90020.14Dominated13,10020.223,30012,60020.07Reference
        200% × BC17,90020.13Dominated13,10020.213,10012,40019.99Reference
    Post-palliative surgery
        50% × BC17,90020.13Dominated13,10020.213,30012,60020.04Reference
        200% × BC17,90020.13Dominated13,10020.213,10012,40020.03Reference
Outcome adjustments
    Quality of life adjustment factors
        Post-PD
            0.817,90019.69Dominated13,10020.01Dominated12,50020.01Reference
            117,90020.18Dominated13,10020.232,90012,50020.04Reference
        Cancer
            0.2517,90020.13Dominated13,10020.212,90012,50020.02Reference
            117,90020.14Dominated13,10020.224,00012,50020.08Reference
    Discount rate (%)
        038,60035.18Dominated29,40035.3590028,90034.81Reference
        511,70015.07Dominated8,30015.125,6007,80015.03Reference
Costs
    Cancer care
        50% × BC17,90020.13Dominated12,90020.2110,90011,00020.04Reference
        200% × BC18,00020.13Dominated13,40020.21Reference15,50020.04Dominated
    Endoscopy
        50% × BC16,00020.13Dominated10,40020.218,0009,00020.04Reference
        200% × BC21,70020.13Dominated18,40020.21Reference19,50020.04Dominated
    PD
        50% × BC14,70020.13Dominated11,40020.21Reference12,10020.04Dominated
        200% × BC24,30020.13Dominated16,40020.2117,50013,30020.04Reference
    Post-PD
        50% × BC15,10020.13Dominated11,80020.21Reference12,30020.04Dominated
        200% × BC23,60020.13Dominated15,60020.2115,70012,90020.04Reference

NOTE: Dominated means less effective and more costly than another strategy. U.S. $ refers to discounted 2007 U.S. dollars.

Abbreviations: BC, base-case scenario; ICER, incremental cost-effectiveness ratio; PD, pancreaticoduodenectomy; QALY, discounted quality-adjusted life years.