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Cost effectiveness of romosozumab versus teriparatide for severe postmenopausal osteoporosis in Japan
Hagino, H. Tanaka, K. Silverman, S. McClung, M. Gandra, S. R. Charokopou, M. Adachi, K. Johnson, B. Stollenwerk, B.
Hagino, H.
Tanaka, K.
Silverman, S.
McClung, M.
Gandra, S. R.
Charokopou, M.
Adachi, K.
Johnson, B.
Stollenwerk, B.
Abstract
Summary
This study assessed the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japan, using bone mineral density (BMD) efficacy data. Results show that romosozumab/alendronate produces greater health benefits at a lower cost than teriparatide/alendronate.
Introduction
This study aims to assess the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japanese women previously treated with bisphosphonates.
Methods
A Markov model was used to assess the relative cost effectiveness of 1 year of romosozumab versus 2 years of teriparatide, both sequenced to alendronate for a total treatment duration of 5 years. Outcomes for a cohort of women with a mean age of 78 years, a T-score ≤−2.5 and a previous fragility fracture were simulated over a lifetime horizon. The analysis was conducted from the perspective of the Japanese healthcare system and used a discount rate of 2% per annum. To inform relative fracture incidence, the bone mineral density (BMD) advantage of romosozumab over teriparatide was translated into relative risks of fracture, using relationships provided by a meta-regression of osteoporosis therapy trials. Outcomes were assessed in terms of lifetime costs (2020 US dollars) and quality-adjusted life years (QALYs).
Results
Base case results showed that, compared with teriparatide/alendronate, romosozumab/alendronate reduced costs by $5134 per patient and yielded 0.045 additional QALYs. Scenario analyses and probabilistic sensitivity analysis confirmed that results are robust to uncertainty in model assumptions and inputs.
Conclusion
Results show that romosozumab/alendronate produces greater health benefits at a lower total cost than teriparatide/alendronate.
Keywords
bone mineral density, cost effectiveness, markov model, osteoporosis, romosozumab, teriparatide
Date
2021
Type
Journal article
Journal
Osteoporosis International
Book
Volume
32
Issue
Page Range
2011-2021
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
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Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
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