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Cost-consequence analysis of continuous denosumab therapy for osteoporosis treatment in South Korea.
Cha, Seungju; Sohn, Minjeong; Yang, Hyowon; Yeh, Eric J; Baek, Ki-Hyun; Ha, Jeonghoon; Ku, Hyemin.
Afiliação
  • Cha S; NDnex, Saebitgongwon-ro 67, Gwangmyeong-si, Gyeonggi-do, 14348, Republic of Korea.
  • Sohn M; Amgen Korea Ltd, Seoul, Republic of Korea.
  • Yang H; Amgen Korea Ltd, Seoul, Republic of Korea.
  • Yeh EJ; Amgen Inc, Thousand Oaks, CA, USA.
  • Baek KH; Internal Medicine, Yeouido St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
  • Ha J; Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
  • Ku H; NDnex, Saebitgongwon-ro 67, Gwangmyeong-si, Gyeonggi-do, 14348, Republic of Korea. hyemin.ku@ndnex.com.
BMC Musculoskelet Disord ; 25(1): 76, 2024 Jan 20.
Article em En | MEDLINE | ID: mdl-38245776
ABSTRACT

BACKGROUND:

Insurance reimbursement provisions in South Korea limit osteoporosis medication availability for patients with T-scores exceeding - 2.5. This study aimed to evaluate the financial impact and fracture prevention of continuous denosumab therapy until a T-score>-2.0 (Dmab-C strategy), versus discontinuation of denosumab after reaching T-score>-2.5 (Dmab-D strategy) in osteoporosis patients.

METHODS:

A cost-consequence analysis from a Korean healthcare system perspective was performed using a newly developed Markov model. The incidence of vertebral and non-vertebral fracture, fracture-related deaths, drug costs, and fracture-treatment costs were estimated and compared between Dmab-C and Dmab-D strategy over a lifetime in eligible patients aged 55 years.

RESULTS:

Base-case analysis revealed that Dmab-C prevented 32.21 vertebral fracture (VF) and 12.43 non-VF events per 100 patients over a lifetime, while reducing 1.29 fracture-related deaths. Lifetime direct healthcare cost saving per patient was KRW 1,354,655 if Dmab-C replaces Dmab-D. When productivity losses were considered, Dmab-C saved KRW 29,025,949 per patient compared to Dmab-D. The additional treatment costs of Dmab-C could be offset by the higher subsequent treatment costs and fracture treatment costs of Dmab-D. The sensitivity analysis showed consistent patterns with results of the base-case analysis.

CONCLUSION:

Continuous treatment using denosumab until osteoporosis patients achieve and maintain a T-score of -2.0 would provide greater clinical and economic benefits in terms of fracture prevention and reduced mortality risks compared to outcomes from discontinuing treatment at a T-score of -2.5 or above. This new treatment strategy would effectively lower the risk of fractures and fracture-related mortality, ultimately leading to lower medical expenses.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Osteoporose / Osteoporose Pós-Menopausa / Fraturas Ósseas / Conservadores da Densidade Óssea Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Female / Humans Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 6_ODS3_enfermedades_notrasmisibles Base de dados: MEDLINE Assunto principal: Osteoporose / Osteoporose Pós-Menopausa / Fraturas Ósseas / Conservadores da Densidade Óssea Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Female / Humans Idioma: En Revista: BMC Musculoskelet Disord Ano de publicação: 2024 Tipo de documento: Article