<p>Freemantle et al CONFIDENTIAL 08 May 2018</p><p>OnabotulinumtoxinA in the treatment of overactive bladder: a cost- effectiveness analysis versus best supportive care in England and Wales</p><p>Nick Freemantle,1 Kristin Khalaf,2 Clara Loveman,3 Sanja Stanisic,4 Dmitry Gultyaev,5 Johanna Lister,5 Marcus Drake6</p><p>1Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK </p><p>2Allergan Inc., 2525 Dupont Drive, Irvine, CA 92612-1599, USA</p><p>3Allergan Ltd, Marlow International, The Parkway, Marlow SL7 1YL, UK</p><p>4LA-SER ANALYTICA, Corso di Porta Nuova 34, Milan 20121, Italy</p><p>5LA-SER ANALYTICA, Meeraner Platz 1, Lörrach 79539, Germany</p><p>6School of Clinical Sciences and Bristol Urological Institute, University of Bristol, Southmead Road, Westbury-on-Trym, Bristol BS10 5NB, UK </p><p>Corresponding author</p><p>Nick Freemantle Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK. Tel: +44 (0)20 7794 0500 ex34756; Fax: +44 (0)20 7794 1224; email: [email protected]</p><p>Target journal: European Journal of Health Economics</p><p>1 Freemantle et al CONFIDENTIAL 08 May 2018</p><p>Online Resource 3 Cost inputs for the Markov model included in the sensitivity analyses and their respective distributions Parameter Input Distribution Min Max Reference (£) value value OnabotulinumtoxinA 138.20 Gamma 116.28 161.69 BNF [44] (100 U vial) Anticholinergics (per 28.31 Gamma 23.819 33.1219 Average monthly cost patient per month) 8 based on market share of generic and branded anticholinergics, Allergan [data on file] and BNF [44] Antibiotics (per 0.59 Gamma 0.4964 0.69028 BNFa [44] course) 2 Incontinence pads 0.25 Gamma 0.2103 0.29249 NHS supply chain (per pad) 5 Catheters for CIC 0.75 Gamma 0.6310 0.87748 NHS supply chain (per catheter) 4 OnabotulinumtoxinA 219.00 Gamma 184.26 256.224 HRG tariff LB17Z code for administrationb 5 hospital outpatient [45] Specialist physician 102.00 Gamma 74.897 108.402 National Schedule of visit 2 Reference Costs [46] Physician visit to treat 63.00 Gamma 53.007 73.7082 Unit costs of health and UTI 7 social care, PSSRU [47] Removal of 1166.00 Gamma 981.06 1364.19 Estimate from NICE temporary SNS 4 CG171: electrodes Nurse led visit (£70 – non- consultant-led face-to-face outpatient – PSSRU 2011); explants procedure (£1096, HRG code AA21Z – but may be less because this is a small procedure) [19] PNE test (one-stage 1485.00 Gamma 1249.4 1737.41 Estimate from NICE CG171 test) 7 One-stage SNS 8641.00 Gamma 7270.4 10109.7 Costs based on estimate implant (electrode 7 from NICE CG171: and modulator implantation (£2441, HRG implants) code AB01Z, complex neurological pain procedure); patient controlled programmer (£500, NHS, checked by Medtronic, 2012); implantable pulse generator (£5700, NHS, checked by Medtronic, 2012) [19] SNS device explant 923.00 Gamma 776.60 1079.88 OPCS-4 code (A70.2 6 Removal of neurostimulator in peripheral nerve) [48,19] SNS surgical revision 592.00 Gamma 498.10 692.623 Maintenance of 5 neurostimulator. Day case/elective inpatient HRG tariff: AB04Z major pain procedures A70.2 maintenance of neurostimulator in </p><p>2 Freemantle et al CONFIDENTIAL 08 May 2018</p><p> peripheral nerve [45,19] SNS battery 6623.00 Gamma 5572.5 7748.72 Based on estimate from replacement 4 NICE CG171: device (£5700 – NICE CG171 does not provide further information); replacement (£923 – HRG A70.2 maintenance of neurostimulator in peripheral nerve) [19] SNS follow-up 319.00 Gamma 268.40 373.221 Neurosurgical consultation physician visit 4 WF01B OP Code 150 First Attendance - Single professional [49] BNF, British National Formulary; CG, clinical guideline; CIC, clean intermittent catheterization; HRG, Healthcare Resource Group; NHS, National Health Service; NICE, National Institute for Health and Care Excellence; PNE, percutaneous nerve evaluation; OPCS-4, Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures (4th revision); PSSRU, Personal Social Services Research Unit; SNS, sacral nerve stimulation; UTI, urinary tract infection</p><p>3</p>