Table 1.

Key unit costs and probabilistic sensitivity analysis parameters

ParameterBase case inputReferenceDetailLowHighAssumed distribution*
Reimbursement/cost ratio, % 87.0 27  — 43.5 1.31 β 
Clinic/HOPD cost ratio, % 38.0 28  — 19 57 β 
HOPD/IP cost ratio, % 35.0 29  — 17.5 52.5 β 
HOPD office visit, $ 115.85 21  APC 5012 57.93 173.78 γ 
Standard inpatient bed day, $ 2420.77 19  Adjusted to 2019 US$ 1210.38 3631.15 γ 
ICU bed day, $ 7181.84 25  Adjusted to 2019 US$ 3590.92 10 772.75 γ 
CT head scan with contrast, $       
 Nonfacility TC 107.76 20  HCPCS 70460 53.88 161.64 γ 
 26; phys. comp. 58.38 20  HCPCS 70460 29.19 87.57 γ 
 TC; APC 480.77 21  APC 8006 240.39 721.16 γ 
MRI brain scan with contrast, $       
 Nonfacility TC 227.77 20  HCPCS 70552 113.89 341.66 γ 
 26; phys. comp. 91.54 20  HCPCS 70552 45.77 137.31 γ 
 TC; APC 855.60 21  APC 8008 427.80 1283.40 γ 
PET scan with contrast, $       
 Nonfacility TC 1375.61 20  HCPCS 78608 687.81 2063.42 γ 
 26; phys. comp. 73.52 20  HCPCS 78608 36.76 110.28 γ 
EEG, $       
 Nonfacility TC 375.89 20  HCPCS 95819 187.95 563.84 γ 
 26; phys. comp. 59.46 20  HCPCS 95819 29.73 89.19 γ 
 TC; APC 252.31 21  APC 85722 126.16 378.47 γ 
Lumbar puncture, $       
 Nonfacility 152.09 20  HCPCS 62270 76.05 228.14 γ 
 Facility 80.37 20  HCPCS 62270 40.19 120.56 γ 
Mechanical ventilation, $ per d 2644.91 25  Adjusted to 2019 US$ 1322.46 3967.37 γ 
Dialysis, $ per d 611.73 20  APC 5401 305.87 917.60 γ 
Vasopressin, $ 301.25 24  NDC: 63323-0302-09 150.63 451.88 γ 
Norepinephrine, $ 77.67 24  NDC: 55390-0002-10; 25 μg/min 38.84 116.51 γ 
Siltuximab, $ 8571.74 24  NDC: 50242-0135-01 4285.87 12 857.61 γ 
Anakinra, $ 155.01 24  NDC: 66658-0234-07; 100 mg 77.51 232.52 γ 
Tocilizumab, $ 4477.30 24  NDC: 50242-0135-01; 800 mg 2238.65 6715.95 γ 
ParameterBase case inputReferenceDetailLowHighAssumed distribution*
Reimbursement/cost ratio, % 87.0 27  — 43.5 1.31 β 
Clinic/HOPD cost ratio, % 38.0 28  — 19 57 β 
HOPD/IP cost ratio, % 35.0 29  — 17.5 52.5 β 
HOPD office visit, $ 115.85 21  APC 5012 57.93 173.78 γ 
Standard inpatient bed day, $ 2420.77 19  Adjusted to 2019 US$ 1210.38 3631.15 γ 
ICU bed day, $ 7181.84 25  Adjusted to 2019 US$ 3590.92 10 772.75 γ 
CT head scan with contrast, $       
 Nonfacility TC 107.76 20  HCPCS 70460 53.88 161.64 γ 
 26; phys. comp. 58.38 20  HCPCS 70460 29.19 87.57 γ 
 TC; APC 480.77 21  APC 8006 240.39 721.16 γ 
MRI brain scan with contrast, $       
 Nonfacility TC 227.77 20  HCPCS 70552 113.89 341.66 γ 
 26; phys. comp. 91.54 20  HCPCS 70552 45.77 137.31 γ 
 TC; APC 855.60 21  APC 8008 427.80 1283.40 γ 
PET scan with contrast, $       
 Nonfacility TC 1375.61 20  HCPCS 78608 687.81 2063.42 γ 
 26; phys. comp. 73.52 20  HCPCS 78608 36.76 110.28 γ 
EEG, $       
 Nonfacility TC 375.89 20  HCPCS 95819 187.95 563.84 γ 
 26; phys. comp. 59.46 20  HCPCS 95819 29.73 89.19 γ 
 TC; APC 252.31 21  APC 85722 126.16 378.47 γ 
Lumbar puncture, $       
 Nonfacility 152.09 20  HCPCS 62270 76.05 228.14 γ 
 Facility 80.37 20  HCPCS 62270 40.19 120.56 γ 
Mechanical ventilation, $ per d 2644.91 25  Adjusted to 2019 US$ 1322.46 3967.37 γ 
Dialysis, $ per d 611.73 20  APC 5401 305.87 917.60 γ 
Vasopressin, $ 301.25 24  NDC: 63323-0302-09 150.63 451.88 γ 
Norepinephrine, $ 77.67 24  NDC: 55390-0002-10; 25 μg/min 38.84 116.51 γ 
Siltuximab, $ 8571.74 24  NDC: 50242-0135-01 4285.87 12 857.61 γ 
Anakinra, $ 155.01 24  NDC: 66658-0234-07; 100 mg 77.51 232.52 γ 
Tocilizumab, $ 4477.30 24  NDC: 50242-0135-01; 800 mg 2238.65 6715.95 γ 

26; phys. comp., physician component; APC, Ambulatory Payment Classification; CT, computed tomography; EEG, electroencephalogram; HCPCS, Healthcare Common Procedure Coding System; HOPD, hospital outpatient department; IP, inpatient hospital; MRI, magnetic resonance imaging; NDC, National Drug Code; PET, positron emission tomography; TC, technical component.

*

The β distribution is applied to model the behavior of random variables limited to finite length. Given that estimates cannot be <0, the β distribution was selected. The β distribution is a suitable model for the random behavior of percentages and proportions. γ distribution is assumed for cost data, specifically for using small sample sizes that often have nonnormal distribution (mean and median are not similar); thus, cost studies often use a γ distribution to address the skewness of cost data that are subject to wide variance and likely a wide range, with a few outliers that affect the mean cost.

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