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Cost-effectiveness of Denosumab for the treatment of postmenopausal osteoporosis.
Osteoporos Int. 2011 Mar; 22(3):967-82.OI

Abstract

Denosumab is an injectable drug that reduces the risk of fractures. The objective was to estimate the cost-effectiveness of denosumab in a Swedish setting, also accounting for poor adherence to treatment. Denosumab is cost-effective, particularly for patients at high risk of fracture and low adherence to oral treatments.

INTRODUCTION

Denosumab is a novel biologic agent developed for the treatment of osteoporosis and osteoporotic fractures that has been shown to reduce the risk of fractures in a phase III trial. The objective of this study was to estimate the cost-effectiveness of denosumab from a societal perspective compared with generic alendronate, branded risedronate, strontium ranelate, and no treatment in a Swedish setting.

METHODS

A Markov cohort model was used to estimate the cost-effectiveness of denosumab given for up to 5 years to a typical Swedish patient population (women aged 71 years, T-score ≤ -2.5 SD and a prevalence of morphometric vertebral fractures of 34%). The model included treatment persistence and residual effect after discontinuation assumed to be equal to the time on treatment. Persistence with the comparator treatments and with denosumab was derived from prescription data and a persistence study, respectively.

RESULTS

The base-case incremental cost-effectiveness ratios were estimated at €27,000, €12,000, €5,000, and €14,000, for denosumab compared with generic alendronate, risedronate, strontium ranelate, and no treatment, respectively. Sub-optimal persistence had the greatest impact in the comparison with generic alendronate, where the difference in drug cost was large.

CONCLUSION

Improving persistence with osteoporosis treatment impacts positively on cost-effectiveness with a larger number of fractures avoided in the population targeted for treatment. Denosumab is a cost-effective alternative to oral osteoporosis treatments, particularly for patients at high risk of fracture and low expected adherence to oral treatments.

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Authors+Show Affiliations

Jönsson B
Stockholm School of Economics, Box 6501, SE 11383 Stockholm, Sweden. Bengt.Jonsson@hhs.se
Ström O
No affiliation info available
Eisman JA
No affiliation info available
Papaioannou A
No affiliation info available
Siris ES
No affiliation info available
Tosteson A
No affiliation info available
Kanis JA
No affiliation info available

MeSH

AgedAged, 80 and overAlendronateAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedBone Density Conservation AgentsCohort StudiesCost-Benefit AnalysisDenosumabEtidronic AcidFemaleHumansMarkov ChainsMiddle AgedOrganometallic CompoundsOsteoporosis, PostmenopausalOsteoporotic FracturesPatient ComplianceQuality-Adjusted Life YearsRANK LigandRisedronic AcidThiophenes

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20936401

Citation

Jönsson, B, et al. "Cost-effectiveness of Denosumab for the Treatment of Postmenopausal Osteoporosis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 22, no. 3, 2011, pp. 967-82.
Jönsson B, Ström O, Eisman JA, et al. Cost-effectiveness of Denosumab for the treatment of postmenopausal osteoporosis. Osteoporos Int. 2011;22(3):967-82.
Jönsson, B., Ström, O., Eisman, J. A., Papaioannou, A., Siris, E. S., Tosteson, A., & Kanis, J. A. (2011). Cost-effectiveness of Denosumab for the treatment of postmenopausal osteoporosis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 22(3), 967-82. https://doi.org/10.1007/s00198-010-1424-x
Jönsson B, et al. Cost-effectiveness of Denosumab for the Treatment of Postmenopausal Osteoporosis. Osteoporos Int. 2011;22(3):967-82. PubMed PMID: 20936401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of Denosumab for the treatment of postmenopausal osteoporosis. AU - Jönsson,B, AU - Ström,O, AU - Eisman,J A, AU - Papaioannou,A, AU - Siris,E S, AU - Tosteson,A, AU - Kanis,J A, Y1 - 2010/10/09/ PY - 2010/07/01/received PY - 2010/09/13/accepted PY - 2010/10/12/entrez PY - 2010/10/12/pubmed PY - 2011/11/4/medline SP - 967 EP - 82 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 22 IS - 3 N2 - UNLABELLED: Denosumab is an injectable drug that reduces the risk of fractures. The objective was to estimate the cost-effectiveness of denosumab in a Swedish setting, also accounting for poor adherence to treatment. Denosumab is cost-effective, particularly for patients at high risk of fracture and low adherence to oral treatments. INTRODUCTION: Denosumab is a novel biologic agent developed for the treatment of osteoporosis and osteoporotic fractures that has been shown to reduce the risk of fractures in a phase III trial. The objective of this study was to estimate the cost-effectiveness of denosumab from a societal perspective compared with generic alendronate, branded risedronate, strontium ranelate, and no treatment in a Swedish setting. METHODS: A Markov cohort model was used to estimate the cost-effectiveness of denosumab given for up to 5 years to a typical Swedish patient population (women aged 71 years, T-score ≤ -2.5 SD and a prevalence of morphometric vertebral fractures of 34%). The model included treatment persistence and residual effect after discontinuation assumed to be equal to the time on treatment. Persistence with the comparator treatments and with denosumab was derived from prescription data and a persistence study, respectively. RESULTS: The base-case incremental cost-effectiveness ratios were estimated at €27,000, €12,000, €5,000, and €14,000, for denosumab compared with generic alendronate, risedronate, strontium ranelate, and no treatment, respectively. Sub-optimal persistence had the greatest impact in the comparison with generic alendronate, where the difference in drug cost was large. CONCLUSION: Improving persistence with osteoporosis treatment impacts positively on cost-effectiveness with a larger number of fractures avoided in the population targeted for treatment. Denosumab is a cost-effective alternative to oral osteoporosis treatments, particularly for patients at high risk of fracture and low expected adherence to oral treatments. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/20936401/Cost_effectiveness_of_Denosumab_for_the_treatment_of_postmenopausal_osteoporosis_ L2 - https://doi.org/10.1007/s00198-010-1424-x DB - PRIME DP - Unbound Medicine ER -