Cost-Effectiveness of Sequential Teriparatide/Zoledronic Acid Compared With Zoledronic Acid Monotherapy for Postmenopausal Osteoporotic Women in China

Abstract

ObjectiveWe aimed to assess the cost-effectiveness of sequential teriparatide/zoledronic acid relative to zoledronic acid monotherapy for postmenopausal osteoporotic women in China.MethodsA previously validated Markov microsimulation model was updated to examine the cost-effectiveness of daily subcutaneous teriparatide for 2 years followed by annual intravenous zoledronic acid for 3 years (sequential teriparatide/zoledronic acid), compared with zoledronic acid monotherapy for 3 years in Chinese women with postmenopausal osteoporosis at ages 65, 70, 75, and 80 from the health care payer perspective.ResultsThe incremental cost-effectiveness ratios (ICERs) (US dollars [$] per quality-adjusted life-year [QALY]) of sequential teriparatide/zoledronic acid vs. zoledronic acid monotherapy was $173,223/QALY at age 65 years, which was much higher than the pre-determined willingness-to-pay (WTP) threshold of $ 31,512/QALY, and the results were similar at other ages. In one-way sensitivity analyses, the two most impactful parameters were the cost of teriparatide and the residual effects of the medications included in this study. Sequential teriparatide/zoledronic acid became cost-effective at age 80 with the cost of teriparatide reduced by 50%. Without the residual effect, the ICER increased to $257,982/QALY. Probabilistic sensitivity analyses shown that the probabilities of zoledronic acid monotherapy being cost-effective were 100% at a WTP of $31,512/QALY.ConclusionsAmong Chinese women with postmenopausal osteoporosis, sequential teriparatide/zoledronic acid was not cost-effective unless the cost of teriparatide was reduced by 50% only for the participants over 80 years.

An NIR-II Probe with High PSMA Affinity Demonstrates an Unexpected Excellent Bone Imaging Ability

“…The bone binding mechanism of Bone-1064 is extremely puzzling since its chemical structure deviates from the requirement of bone targeting . The available bone probes or therapeutic generally possess at least one phosphate or an iminodiacetate group, which could bind to the HA or chelate Ca 2+ in the bone. ,− However, there was no such bone-targeting motif in Bone-1064 . Moreover, according to previous studies, no evidence could confirm the expression of PSMA in the bone, and the previously reported EuK-based probes had never demonstrated any bone affinity yet.…”

Zoledronic acid for osteoporosis and associated low-energy fractures

“…Показано, что назначение антирезорбтивных препаратов после терипаратида, абалопаратида или ромосозумаба позволяет увеличить прирост МПК и дополнительно снизить риск переломов тел позвонков [63]. Совместное использование золедроновой кислоты и терипаратида также сопровождалось повышением эффективности лечения по сравнению с монотерапией, однако требуется проведение дополнительных клинических исследований, затрагивающих как вопросы эффективности, так и доступности комбинированной терапии [64,65].…”