Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective

Purpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old,...

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Main Authors: Stuart Silverman, Irene Agodoa, Morgan Kruse, Anju Parthan, Eric Orwoll
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Osteoporosis
Online Access:http://dx.doi.org/10.1155/2015/627631
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author Stuart Silverman
Irene Agodoa
Morgan Kruse
Anju Parthan
Eric Orwoll
author_facet Stuart Silverman
Irene Agodoa
Morgan Kruse
Anju Parthan
Eric Orwoll
author_sort Stuart Silverman
collection DOAJ
description Purpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old, with a BMD T-score of −2.12 and a vertebral fracture prevalence of 23%. During each 6-month Markov cycle, patients could have experienced a hip, vertebral or nonhip, nonvertebral (NHNV) osteoporotic fracture, remained in a nonfracture state, remained in a postfracture state, or died. Background fracture risks, mortality rates, persistence rates, health utilities, and medical and drug costs were derived from published sources. Previous PMO studies were used for drug efficacy in reducing fracture risk. Lifetime expected costs and quality-adjusted life-years (QALYs) were estimated for denosumab, generic alendronate, risedronate, ibandronate, teriparatide, and zoledronate. Results. Denosumab had an incremental cost-effectiveness ratio (ICER) of $16,888 compared to generic alendronate and dominated all other treatments. Results were most sensitive to changes in costs of denosumab and the relative risk of hip fracture. Conclusion. Despite a higher annual treatment cost compared to other medications, denosumab is cost-effective compared to other osteoporotic treatments in older osteoporotic US men.
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spelling doaj-art-2c819bd5149945ddbd854ee449e187e92025-08-20T02:24:04ZengWileyJournal of Osteoporosis2090-80592042-00642015-01-01201510.1155/2015/627631627631Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer PerspectiveStuart Silverman0Irene Agodoa1Morgan Kruse2Anju Parthan3Eric Orwoll4Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USAAmgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USAOptum, 950 Winter Street, Suite 2800, Waltham, MA 02451, USAOptum, 950 Winter Street, Suite 2800, Waltham, MA 02451, USAOregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USAPurpose. To evaluate the cost-effectiveness of denosumab versus other osteoporotic treatments in older men with osteoporosis from a US payer perspective. Methods. A lifetime cohort Markov model previously developed for postmenopausal osteoporosis (PMO) was used. Men in the model were 78 years old, with a BMD T-score of −2.12 and a vertebral fracture prevalence of 23%. During each 6-month Markov cycle, patients could have experienced a hip, vertebral or nonhip, nonvertebral (NHNV) osteoporotic fracture, remained in a nonfracture state, remained in a postfracture state, or died. Background fracture risks, mortality rates, persistence rates, health utilities, and medical and drug costs were derived from published sources. Previous PMO studies were used for drug efficacy in reducing fracture risk. Lifetime expected costs and quality-adjusted life-years (QALYs) were estimated for denosumab, generic alendronate, risedronate, ibandronate, teriparatide, and zoledronate. Results. Denosumab had an incremental cost-effectiveness ratio (ICER) of $16,888 compared to generic alendronate and dominated all other treatments. Results were most sensitive to changes in costs of denosumab and the relative risk of hip fracture. Conclusion. Despite a higher annual treatment cost compared to other medications, denosumab is cost-effective compared to other osteoporotic treatments in older osteoporotic US men.http://dx.doi.org/10.1155/2015/627631
spellingShingle Stuart Silverman
Irene Agodoa
Morgan Kruse
Anju Parthan
Eric Orwoll
Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
Journal of Osteoporosis
title Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
title_full Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
title_fullStr Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
title_full_unstemmed Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
title_short Denosumab for Elderly Men with Osteoporosis: A Cost-Effectiveness Analysis from the US Payer Perspective
title_sort denosumab for elderly men with osteoporosis a cost effectiveness analysis from the us payer perspective
url http://dx.doi.org/10.1155/2015/627631
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