| Cost-effectiveness of denosumab in the treatment of postmenopausal osteoporosis in Canada. | |
| | |
MedLine Citation:
|
PMID: 23035625 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Abstract OBJECTIVE: Denosumab is a novel biologic agent approved in Canada for treatment of postmenopausal osteoporosis (PMO) in women at high risk for fracture or who have failed or are intolerant to other osteoporosis therapies. This study estimated cost-effectiveness of denosumab versus usual care from the perspective of the Ontario public payer. METHODS: A previously published PMO Markov cohort model was adapted for Canada to estimate cost-effectiveness of denosumab. The primary analysis included women with demographic characteristics similar to those from the pivotal phase III denosumab PMO trial (FREEDOM; age 72 years, femoral neck BMD T-score -2.16 SD, vertebral fracture prevalence 23.6%). Three additional scenario subgroups were examined including women: 1) at high fracture risk, defined in FREEDOM as having at least two of three risk factors (age 70+; T-score ≤-3.0 SD at lumbar spine, total hip, or femoral neck; prevalent vertebral fracture); 2) age 75+; and 3) intolerant or contraindicated to oral bisphosphonates (BPs). Analyses were conducted over a lifetime horizon comparing denosumab to usual care ('no therapy', alendronate, risedronate, or raloxifene [subgroup 3 only]). The analysis considered treatment-specific persistence and post-discontinuation residual efficacy, as well as treatment-specific adverse events. Both deterministic and probabilistic sensitivity analyses were conducted. RESULTS: The multi-therapy comparisons resulted in incremental cost-effectiveness ratios for denosumab versus alendronate of $60,266 (2010 CDN$) (primary analysis) and $27,287 per quality-adjusted life year gained for scenario subgroup 1. Denosumab dominated all therapies in the remaining scenarios. LIMITATIONS: Key limitations include a lack of long-term, real-world, Canadian data on persistence with denosumab as well as an absence of head-to-head clinical data, leaving us to rely on meta-analyses based on trials comparing treatment to placebo. CONCLUSIONS: Denosumab may be cost-effective compared to oral PMO treatments for women at high risk of fractures and those who are intolerant and/or contraindicated to oral BPs. |
| | |
Authors:
|
D Chau; Dl Becker; Me Coombes; G Ioannidis; Jd Adachi; R Goeree |
Related Documents
:
|
12660205 - Acute pesticide-related illnesses among working youths, 1988-1999. 23602465 - Gardnerella vaginalis-associated bacterial vaginosis in bulgarian women. 17476325 - Characteristics associated with citation rate of the medical literature. 23565985 - The eroticism of internet cruising as a self-contained behaviour: a multivariate analys... 9259375 - Analysis of 31 families with an apparently autosomal-dominant transmission of migraine ... 12568825 - Effecting behavior change: awareness of family history. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-10-5 |
Journal Detail:
|
Title: Journal of medical economics Volume: - ISSN: 1941-837X ISO Abbreviation: J Med Econ Publication Date: 2012 Oct |
Date Detail:
|
Created Date: 2012-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9892255 Medline TA: J Med Econ Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fitness and metabolic syndrome in obese fatty liver children.
Next Document: The Direct and Indirect Costs of Long Bone Fractures in a Working Age U.S. Population.