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

Overview

Journal Front Public Health

Specialty Public Health

Date 2022 Mar 14

PMID 35284380

Authors

Ruxu You

Jinyu Liu

Lei Ke

Guangyi Yu

Yu Zhang

Takahiro Mori

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to assess the cost-effectiveness of sequential teriparatide/zoledronic acid relative to zoledronic acid monotherapy for postmenopausal osteoporotic women in China.

Methods: A 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.

Results: The 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.

Conclusions: Among 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.

Citing Articles

[Teriparatide regulates osteoblast differentiation in high-glucose microenvironment through the cAMP/PKA/CREB signaling pathway].

Hou T, Qin Y, Zhang Y, Wen G, Qi M, Dong W Nan Fang Yi Ke Da Xue Xue Bao. 2023; 43(1):39-45.

PMID: 36856208 PMC: 9978729. DOI: 10.12122/j.issn.1673-4254.2023.01.05.

A systematic review of cost‑effectiveness analyses of sequential treatment for osteoporosis.

Yu G, Tong S, Liu J, Wan Y, Wan M, Li S Osteoporos Int. 2022; 34(4):641-658.

PMID: 36527476 DOI: 10.1007/s00198-022-06626-1.

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