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Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed by Alendronate Versus Teriparatide Followed by Alendronate in Postmenopausal Women With Osteoporosis in the United States.
Ann Pharmacother. 2019 02; 53(2):134-143.AP

Abstract

BACKGROUND

The US Food and Drug Administration has recently approved abaloparatide (ABL) for treatment of women with postmenopausal osteoporosis (PMO) at high risk of fracture. With increasing health care spending and drug prices, it is important to quantify the value of newly available treatment options for PMO.

OBJECTIVE

To determine cost-effectiveness of ABL compared with teriparatide (TPTD) for treatment of women with PMO in the United States.

METHODS

A discrete-event simulation (DES) model was developed to assess cost-effectiveness of ABL from the US health care perspective. The model included three 18-month treatment strategies with either placebo (PBO), TPTD, or ABL, all followed by additional 5-year treatment with alendronate (ALN). High-risk patients were defined as women with PMO ⩾65 years old with a prior vertebral fracture. Baseline clinical event rates, risk reductions, and patient characteristics were based on the Abaloparatide Comparator Trial in Vertebral Endpoints (ACTIVE) trial.

RESULTS

Over a 10-year period, the DES model yielded average total discounted per-patient costs of $10 212, $46 783, and $26 837 and quality-adjusted life-years (QALYs) of 6.742, 6.781, and 6.792 for PBO/ALN, TPTD/ALN, and ABL/ALN, respectively. Compared with TPTD/ALN, ABL/ALN accrued higher QALYs at lower cost and produced an incremental cost-effectiveness ratio (ICER) of $333 266/QALY relative to PBO/ALN. In high-risk women, ABL/ALN also had more QALYs and less cost over TPTD/ALN and yielded an ICER of $188 891/QALY relative to PBO/ALN. Conclusion and Relevance: ABL is a dominant treatment strategy over TPTD. In women with PMO at high risk of fracture, ABL is an alternative cost-effective treatment.

Authors+Show Affiliations

1 Western University of Health Sciences, Pomona, CA, USA.2 University of Southern California, Los Angeles, CA, USA.3 Russell Becker Consulting, Chicago, IL, USA.4 Radius Health, Inc, Parsippany, NJ, USA.

Pub Type(s)

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

Language

eng

PubMed ID

30160186

Citation

Le, Quang A., et al. "Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed By Alendronate Versus Teriparatide Followed By Alendronate in Postmenopausal Women With Osteoporosis in the United States." The Annals of Pharmacotherapy, vol. 53, no. 2, 2019, pp. 134-143.
Le QA, Hay JW, Becker R, et al. Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed by Alendronate Versus Teriparatide Followed by Alendronate in Postmenopausal Women With Osteoporosis in the United States. Ann Pharmacother. 2019;53(2):134-143.
Le, Q. A., Hay, J. W., Becker, R., & Wang, Y. (2019). Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed by Alendronate Versus Teriparatide Followed by Alendronate in Postmenopausal Women With Osteoporosis in the United States. The Annals of Pharmacotherapy, 53(2), 134-143. https://doi.org/10.1177/1060028018798034
Le QA, et al. Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed By Alendronate Versus Teriparatide Followed By Alendronate in Postmenopausal Women With Osteoporosis in the United States. Ann Pharmacother. 2019;53(2):134-143. PubMed PMID: 30160186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness Analysis of Sequential Treatment of Abaloparatide Followed by Alendronate Versus Teriparatide Followed by Alendronate in Postmenopausal Women With Osteoporosis in the United States. AU - Le,Quang A, AU - Hay,Joel W, AU - Becker,Russell, AU - Wang,Yamei, Y1 - 2018/08/30/ PY - 2018/8/31/pubmed PY - 2020/2/6/medline PY - 2018/8/31/entrez KW - abaloparatide KW - cost-effectiveness analysis KW - cost-utility analysis KW - economic analysis KW - osteoporosis KW - postmenopausal women KW - teriparatide SP - 134 EP - 143 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 53 IS - 2 N2 - BACKGROUND: The US Food and Drug Administration has recently approved abaloparatide (ABL) for treatment of women with postmenopausal osteoporosis (PMO) at high risk of fracture. With increasing health care spending and drug prices, it is important to quantify the value of newly available treatment options for PMO. OBJECTIVE: To determine cost-effectiveness of ABL compared with teriparatide (TPTD) for treatment of women with PMO in the United States. METHODS: A discrete-event simulation (DES) model was developed to assess cost-effectiveness of ABL from the US health care perspective. The model included three 18-month treatment strategies with either placebo (PBO), TPTD, or ABL, all followed by additional 5-year treatment with alendronate (ALN). High-risk patients were defined as women with PMO ⩾65 years old with a prior vertebral fracture. Baseline clinical event rates, risk reductions, and patient characteristics were based on the Abaloparatide Comparator Trial in Vertebral Endpoints (ACTIVE) trial. RESULTS: Over a 10-year period, the DES model yielded average total discounted per-patient costs of $10 212, $46 783, and $26 837 and quality-adjusted life-years (QALYs) of 6.742, 6.781, and 6.792 for PBO/ALN, TPTD/ALN, and ABL/ALN, respectively. Compared with TPTD/ALN, ABL/ALN accrued higher QALYs at lower cost and produced an incremental cost-effectiveness ratio (ICER) of $333 266/QALY relative to PBO/ALN. In high-risk women, ABL/ALN also had more QALYs and less cost over TPTD/ALN and yielded an ICER of $188 891/QALY relative to PBO/ALN. Conclusion and Relevance: ABL is a dominant treatment strategy over TPTD. In women with PMO at high risk of fracture, ABL is an alternative cost-effective treatment. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/30160186/Cost_effectiveness_Analysis_of_Sequential_Treatment_of_Abaloparatide_Followed_by_Alendronate_Versus_Teriparatide_Followed_by_Alendronate_in_Postmenopausal_Women_With_Osteoporosis_in_the_United_States_ L2 - https://journals.sagepub.com/doi/10.1177/1060028018798034?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -