Cost-effectiveness intervention thresholds for romosozumab and teriparatide in the treatment of osteoporosis in the UK
Authors' conclusion
The results of this study indicate that sequential romosozumab-to-alendronate or teriparatide-to-alendronate treatment can be a cost-effective treatment option for postmenopausal women at very high risk of fracture.
Study context
- Population
- Simulated women aged 50 to 90 years with a recent major osteoporotic fracture (MOF), hip or spine fracture, followed from start of a 5-year treatment until age 100 years or death, UK setting
- Comparison
- Sequential romosozumab-to-alendronate or teriparatide-to-alendronate vs alendronate alone
- Outcome
- CEIT: 10-year probability of MOF at which treatment becomes cost-effective
Methodological detailsmicrosimulation model with a Markov structure, healthcare perspective, efficacy from phase III RCTs, willingness to pay (WTP) £30,000
- Microsimulation model with a Markov structure
- Healthcare perspective
- Efficacy from phase III RCTs
- WTP £30,000
Main finding
As reported in the abstract
CEIT (10-year MOF probability) at WTP of £30,000, base case
Romosozumab-to-alendronate
18-35%
Teriparatide-to-alendronate
27-57%
Further findings
Cost-effectiveness intervention threshold (CEITs) vs National Osteoporosis Guideline Group (NOGG) clinical thresholds
- Romosozumab-to-alendronate CEITs lower than clinical thresholds from age 70 years
- Teriparatide-to-alendronate CEITs higher than clinical thresholds irrespective of age; cost-effective scenarios with strong clinical risk factors in addition to a recent sentinel fracture
Sensitivity analyses
- Sensitive to drug pricing; relatively insensitive to treatment duration, romosozumab persistence assumptions and site of sentinel fracture
Original publication
Cost-effectiveness intervention thresholds for romosozumab and teriparatide in the treatment of osteoporosis in the UK. Osteoporos Int. Published 4 October 2024. doi:10.
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