| Summary: | Given issues with the stability of the sponsor's probabilistic analysis (i.e., wide variation in the incremental cost-effectiveness ratios [ICERs] at each model run due in part to the wide credible intervals within the sponsor's submitted network meta-analysis [NMA]), CADTH conducted reanalyses deterministically for both the anti-tumour necrosis factor (TNF) alpha naive populations and anti-TNF alpha exposed populations as distinct populations. CADTH also accounted for limitations by including relevant comparators, revising the probability of surgery and of post-surgery complications, adjusting costs and resource use, and switching off dose escalation and the loss and regaining of response. In the anti-TNF alpha naive population, subcutaneous (SC) vedolizumab was dominated by tofacitinib (i.e., tofacitinib was associated with more quality-adjusted life-years [QALYs] at a lower cost compared with vedolizumab SC). In the anti-TNF alpha exposed population, vedolizumab SC was found to be the optimal therapy at a willingness to pay (WTP) above $1,152,959 per QALY gained when compared with tofacitinib. Between a WTP threshold of $117,761 to $1,152,959 per QALY gained, tofacitinib would be the optimal therapy, while below a WTP threshold $117,761 per QALY gained, conventional therapy would be the optimal therapy
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