Cost-effectiveness of combined oral bisphosphonate therapy and falls prevention exercise for fracture prevention in the USA

Mori, Takahiro; Crandall, Carolyn J.; Ganz, David A.

doi:10.1007/s00198-016-3772-7

Cited by 30 publications

(92 citation statements)

References 36 publications

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“… We used an updated version of previously validated Markov microsimulation models to perform a cost‐effectiveness analysis among hypothetical cohorts of community‐dwelling osteoporotic women with previous vertebral fracture in the US at various ages of therapy initiation (65, 70, 75, and 80 years old). We chose to focus on white women for this analysis because they represent a high‐risk group for fracture . We estimated total costs in 2018 US dollars and quality‐adjusted life years (QALYs) to obtain incremental cost‐effectiveness ratios (ICERs), which represent the cost per QALY gained for one strategy compared with the other, over a lifetime horizon (until a participant reached age 105 or died).…”

Section: Methodsmentioning

confidence: 99%

“…We used tracker variables for fractures and interventions to incorporate memory of previous events from one cycle to the next in the model. The details of the model structure can be found in our previously published work and its technical appendix …”

Section: Methodsmentioning

confidence: 99%

“…The other model parameters can be found in our earlier publication and its technical appendix . CPT = Current Procedural Terminology.…”

Section: Methodsmentioning

confidence: 99%

“…We estimated the relative efficacy of alendronate in the community by assuming a linear relationship between relative risk reduction and adherence. For example, if we assumed the adherence rate was 60% in the community, the relative efficacy in the community was estimated to be 0.75, based on 60% (community adherence)/80% (adherence of clinical trials) . We applied the same assumption to teriparatide for consistency.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, we assumed that those who were on treatments and developed a fracture continued a total course of treatment with the same persistence and adherence, as there does not appear to be an association between prior history of fracture and persistence or adherence with osteoporosis therapy . Those who initially did not start treatments continued not to be on treatments after a fracture in this study to keep the model parsimonious …”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

Cost‐Effectiveness of Sequential Teriparatide/Alendronate Versus Alendronate‐Alone Strategies in High‐Risk Osteoporotic Women in the US: Analyzing the Impact of Generic/Biosimilar Teriparatide

2019

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Teriparatide, currently only available in brand form in the United States, is a costly drug approved for the treatment of postmenopausal osteoporotic women who are at high risk of fracture. Because market exclusivity for brand teriparatide expired in August 2019 in the US, we sought to understand the potential health economic impact of the availability of generic or biosimilar (generic/biosimilar) teriparatide. We examined the cost‐effectiveness of daily teriparatide for 2 years followed by weekly alendronate for 10 years (ie, sequential teriparatide/alendronate) compared with alendronate alone for 10 years in community‐dwelling white osteoporotic women with prior vertebral fracture at ages 65, 70, 75, and 80. Using an updated version of previously validated Markov microsimulation models, we obtained incremental cost‐effectiveness ratios (ICERs) (dollars [$] per quality‐adjusted life year [QALY]) with a willingness‐to‐pay (WTP) of $150,000 per QALY from a societal perspective with a lifelong time horizon. In the base case, we estimated the annual cost of teriparatide to be $20,161, based on the assumption of 10% brand usage (at a cost of $27,618) and 90% generic/biosimilar usage (priced 30% lower than brand). The ICERs of sequential teriparatide/alendronate compared with alendronate alone were greater than $280,000 per QALY at all ages examined. In deterministic sensitivity analyses, results were sensitive to teriparatide's cost, with the cost of a generic/biosimilar product needing to be 65% to 85% lower than brand for sequential teriparatide/alendronate to be cost‐effective. In probabilistic sensitivity analyses, under the assumption that the annual cost of teriparatide was $20,161, the probabilities of sequential teriparatide/alendronate being cost‐effective were less than 4% at a WTP of $150,000 per QALY. In conclusion, among community‐dwelling older osteoporotic women with prior vertebral fracture in the US, even with the potential availability of generic/biosimilar teriparatide, sequential teriparatide/alendronate would not be cost‐effective unless the cost of generic/biosimilar teriparatide were heavily discounted with respect to the current brand cost. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The other model parameters can be found in our earlier publication and its technical appendix . CPT = Current Procedural Terminology.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Cost‐Effectiveness of Sequential Teriparatide/Alendronate Versus Alendronate‐Alone Strategies in High‐Risk Osteoporotic Women in the US: Analyzing the Impact of Generic/Biosimilar Teriparatide

2019

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Rehabilitation Treatments for Chronic Musculoskeletal Pain

Sehgal¹,

Laursen²,

Falco³

et al. 2018

Handbook of Pain and Palliative Care

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Cost-effectiveness of denosumab versus oral alendronate for elderly osteoporotic women in Japan

2017

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Among community-dwelling elderly osteoporotic women in Japan, denosumab every 6 months for 5 years is cost-saving or cost-effective at a conventionally accepted threshold of willingness-to-pay at all ages examined, compared with weekly alendronate for 5 years. This study provides insight to clinicians and policymakers regarding the relative economic value of osteoporosis treatments in elderly women.

show abstract

Cost-effectiveness of combined oral bisphosphonate therapy and falls prevention exercise for fracture prevention in the USA

Cited by 30 publications

References 36 publications

Cost‐Effectiveness of Sequential Teriparatide/Alendronate Versus Alendronate‐Alone Strategies in High‐Risk Osteoporotic Women in the US: Analyzing the Impact of Generic/Biosimilar Teriparatide

Cost‐Effectiveness of Sequential Teriparatide/Alendronate Versus Alendronate‐Alone Strategies in High‐Risk Osteoporotic Women in the US: Analyzing the Impact of Generic/Biosimilar Teriparatide

Rehabilitation Treatments for Chronic Musculoskeletal Pain

Cost-effectiveness of denosumab versus oral alendronate for elderly osteoporotic women in Japan

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