Cost-effectiveness of romosozumab for the treatment of postmenopausal women with osteoporosis at high risk of fracture in Belgium
Journal article
Gielen, Evelien, Aldvén, Martina, Kanis, John Anthony, Borgström, F., Senior, Emmanuelle and Willems, Damon. (2024). Cost-effectiveness of romosozumab for the treatment of postmenopausal women with osteoporosis at high risk of fracture in Belgium. Osteoporosis International. 35, pp. 1173-1183. https://doi.org/10.1007/s00198-024-07043-2
Authors | Gielen, Evelien, Aldvén, Martina, Kanis, John Anthony, Borgström, F., Senior, Emmanuelle and Willems, Damon |
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Abstract | Summary: 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. |
Keywords | Osteoporosis; Economic evaluation; Imminent fracture risk; Recent fracture; Cost-effectiveness ; Markov- microsimulation model |
Year | 01 Jan 2024 |
Journal | Osteoporosis International |
Journal citation | 35, pp. 1173-1183 |
Publisher | Springer UK |
ISSN | 0937-941X |
Digital Object Identifier (DOI) | https://doi.org/10.1007/s00198-024-07043-2 |
Web address (URL) | https://link.springer.com/article/10.1007/s00198-024-07043-2 |
Open access | Open access |
Research or scholarly | Research |
Page range | 1173-1183 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 02 Apr 2024 |
Publication process dates | |
Accepted | 20 Feb 2024 |
Deposited | 02 Sep 2024 |
Additional information | © The Author(s) 2024 |
This article is licensed under a Creative Commons Attri- | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/90x78/cost-effectiveness-of-romosozumab-for-the-treatment-of-postmenopausal-women-with-osteoporosis-at-high-risk-of-fracture-in-belgium
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Publisher's version
OA_Kanis_2024_Cost_effectiveness_of_romosozumab_for_the.pdf | |
License: CC BY-NC-ND 4.0 | |
File access level: Open |
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