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Intervention thresholds for denosumab in the UK using a FRAX®-based cost-effectiveness analysis.
Summary
Denosumab is a cost-effective treatment for osteoporosis in UK women with a major osteoporotic fracture risk of approximately 20%. It is recommended for those unable to take or tolerate generic alendronate.
Area of Science:
- Health economics
- Osteoporosis management
- Pharmacoeconomics
Background:
- Denosumab is a novel biologic agent for osteoporosis treatment.
- Phase-III trials show denosumab reduces fracture risk.
- This study evaluates the cost-effectiveness of denosumab in UK women.
Purpose of the Study:
- To conduct a health economic analysis of denosumab for osteoporosis in UK women.
- To estimate fracture probabilities at which denosumab is cost-effective compared to alternatives.
- To utilize the FRAX® tool for risk assessment.
Main Methods:
- Adaptation of a published Markov model.
- Inclusion of fracture and mortality risk assessments using FRAX®.
- Consideration of treatment persistence and residual effects.
Main Results:
- Denosumab is cost-effective compared to no treatment from age 70, or at ~20% major osteoporotic fracture probability.
- Denosumab cost-effectively replaces strontium, risedronate, and generic alendronate at specific fracture probability thresholds.
- Cost-effectiveness is evaluated against a willingness-to-pay of £30,000 per quality-adjusted life year.
Conclusions:
- FRAX® enables cost-effectiveness threshold estimation for various clinical risk factors.
- Denosumab is a cost-effective option for osteoporosis in women with high fracture risk.
- It is particularly beneficial for patients unable to use generic alendronate.
