Article (Scientific journals)
Potential cost-effectiveness of denosumab for the treatment of postmenopausal osteoporotic women.
Hiligsmann, Mickaël; Reginster, Jean-Yves
2010In BONE, 47, p. 34-40
Peer Reviewed verified by ORBi
 

Files


Full Text
Bone3_Hiligsmann.pdf
Publisher postprint (420.97 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
cost-effectiveness; denosumab; osteoporosis; postmenopausal women; treatment
Abstract :
[en] Denosumab has recently been shown to be safe and to significantly reduce the risk of vertebral, hip and non-vertebral fractures in the "Fracture REduction Evaluation of Denosumab in Osteoporosis every 6Months" (FREEDOM) Trial. Besides the clinical profile of a new drug, it becomes increasingly important to assess whether the drug represents good value for money. This study aims to examine the potential cost-effectiveness of denosumab in the treatment of postmenopausal osteoporotic women. An updated version of a validated Markov microsimulation model was used to estimate the cost (euro2009) per quality-adjusted life-year (QALY) gained of a 3-year denosumab treatment compared with no treatment. The model was populated with cost and epidemiological data for Belgium from a health-care perspective and the base-case population was defined from the FREEDOM Trial. The effect of denosumab after treatment cessation was conservatively assumed to decline linearly over 1year. Uncertainty was investigated using one-way and probabilistic sensitivity analyses. In particular, additional analyses were performed in populations (over 60years) where osteoporosis medications are currently reimbursed in many European countries, i.e. with bone mineral density (BMD) T-score</=-2.5 or prevalent vertebral fracture. In the base-case analysis, the cost per QALY gained of denosumab compared with no treatment was estimated at euro28,441. This value decreased to euro15,532 and to euro11,603 for women with a BMD T-score of -2.5 or prevalent vertebral fracture, respectively. Additional analyses showed that the cost-effectiveness of denosumab fall below commonly accepted threshold of euro30,000per QALY gained for women with a BMD T-score </=-2.5 or prevalent vertebral fracture, over the entire age range examined (60-80years). The results were robust under a wide range of plausible assumptions. In conclusion, this study suggests, on the basis of currently available data, that denosumab is cost-effective compared with no treatment for postmenopausal Belgian women with low bone mass and who are similar to patients included in the FREEDOM Trial. In addition, denosumab was found to be cost-effective in population currently reimbursed in Europe with T-score</=-2.5 or prevalent vertebral fracture, aged 60years and above. Additional data are needed on the relative cost-effectiveness compared with other anti-osteoporotic agents and on the long-term safety of denosumab.
Disciplines :
Special economic topics (health, labor, transportation...)
Rheumatology
Author, co-author :
Hiligsmann, Mickaël ;  Université de Liège - ULiège > HEC-Ecole de gestion : UER > Economie industrielle
Reginster, Jean-Yves  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Language :
English
Title :
Potential cost-effectiveness of denosumab for the treatment of postmenopausal osteoporotic women.
Publication date :
2010
Journal title :
BONE
ISSN :
8756-3282
eISSN :
1873-2763
Publisher :
Elsevier Science, New York, United States - New York
Volume :
47
Pages :
34-40
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Available on ORBi :
since 12 April 2010

Statistics


Number of views
118 (5 by ULiège)
Number of downloads
2 (2 by ULiège)

Scopus citations®
 
36
Scopus citations®
without self-citations
28
OpenCitations
 
32

Bibliography


Similar publications



Contact ORBi