Cost-effectiveness of romosozumab for the treatment of postmenopausal women with osteoporosis at high risk of fracture in Belgium.
Osteoporos Int
; 35(7): 1173-1183, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38565690
ABSTRACT
This study evaluated the cost-effectiveness of sequential treatment with romosozumab-to-alendronate compared to alendronate monotherapy and teriparatide-to-alendronate, in postmenopausal osteoporotic women from a Belgian healthcare perspective. Romosozumab-to-alendronate was found to be cost-effective compared to alendronate monotherapy and dominant compared to teriparatide-to-alendronate for osteoporotic women at high risk of fracture in Belgium. PURPOSE:
This study aimed to evaluate the cost-effectiveness of sequential treatment with romosozumab followed by alendronate compared to alendronate monotherapy and teriparatide followed by alendronate, in postmenopausal osteoporotic women at high risk of fracture, from a Belgian healthcare perspective. Romosozumab is reimbursed in Belgium since December 2021.METHODS:
A Markov microsimulation model was used to evaluate the cost-effectiveness of romosozumab-to-alendronate compared to alendronate monotherapy and to teriparatide-to-alendronate over a lifetime horizon. Patients transition between five different health states every 6 months based on fracture risks or death. The model was populated with Belgium-specific epidemiological and cost data, where available. The fracture risk reduction of romosozumab treatment was collated from the ARCH study, and from a published network meta-analysis. Costs were included from a healthcare perspective (NIHDI). Cost-effectiveness was reported in terms of costs per quality-adjusted life year (QALY), reported in Euro () 2022. Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed.RESULTS:
Romosozumab-to-alendronate was associated with 0.12 additional QALYs at an additional cost of 2314 compared to alendronate monotherapy, resulting in an ICER of 19,978. Compared to teriparatide-to-alendronate, romosozumab-to-alendronate was found to be dominant, with higher QALYs and lower costs. The base-case results were robust to uncertainty in the input parameters when conducting the sensitivity analysis.CONCLUSION:
Sequential treatment with romosozumab followed by alendronate was found to be cost-effective compared to alendronate monotherapy and dominant compared to teriparatide followed by alendronate for postmenopausal women with osteoporosis at high risk of fracture in Belgium.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Osteoporose Pós-Menopausa
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Cadeias de Markov
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Custos de Medicamentos
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Análise Custo-Benefício
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Anos de Vida Ajustados por Qualidade de Vida
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Alendronato
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Teriparatida
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Conservadores da Densidade Óssea
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Fraturas por Osteoporose
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Anticorpos Monoclonais
Limite:
Aged
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Female
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Humans
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Osteoporos Int
Assunto da revista:
METABOLISMO
/
ORTOPEDIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Bélgica