Back to Journals » ClinicoEconomics and Outcomes Research » Volume 7

Cost-utility of denosumab for the treatment of postmenopausal osteoporosis in Spain

Authors Darbà J, Kaskens L, Vilela FS, Lothgren M

Received 29 November 2014

Accepted for publication 13 January 2015

Published 9 February 2015 Volume 2015:7 Pages 105—117


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Giorgio Colombo

Josep Darbà,1 Lisette Kaskens,2 Francesc Sorio Vilela,3 Mickael Lothgren4

1Department of Economics, Universitat de Barcelona, 2BCN Health Economics and Outcomes Research SL, 3Amgen SA, Barcelona, Spain; 4Amgen (Europe) GmbH, Zug, Switzerland

Background: The objective of this study was to estimate the cost-effectiveness of denosumab for fracture prevention compared with no treatment, generic bisphosphonates, and strontium ranelate in a cohort of osteoporotic postmenopausal women in Spain.
Methods: A Markov model represented the possible health state transitions of Spanish postmenopausal women from initiation of fracture prevention treatment until age 100 years or death. The perspective was that of the Spanish National Health System. Fracture efficacy data for denosumab were taken from a randomized controlled trial. Fracture efficacy data for alendronate, ibandronate, risedronate, and strontium ranelate were taken from an independent meta-analysis. Data on the incidence of fractures in Spain were either taken from the published literature or derived from Swedish data after applying a correction factor based on the reported incidence from each country. Resource use in each health state was obtained from the literature, or where no data had been published, conservative assumptions were made. Utility values for the various fracture health states were taken from published sources. The primary endpoints of the model were life-years gained, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios for denosumab against the comparators.
Results: Denosumab reduced the risk of fractures compared with either no treatment or the other active interventions, and produced the greatest gains in life-years and QALYs. With an annual acquisition cost of €417.34 for denosumab, the incremental cost-effectiveness ratios for denosumab versus no treatment, alendronate, risedronate, and ibandronate were estimated at €6,823, €16,294, €4,895, and €2,205 per QALY gained, respectively. Denosumab dominated strontium ranelate. Sensitivity analyses confirmed the robustness of these findings.
Conclusion: Our analyses show that denosumab is a cost-effective intervention for fracture prevention in osteoporotic postmenopausal women in Spain compared with alendronate and risedronate, and is a dominant treatment option compared with strontium ranelate.

Keywords: osteoporosis, post-menopausal, cost-utility, denosumab, Spain

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

Darbà J, Ramírez G, Sicras A, García-Bujalance L, Torvinen S, Sánchez-de la Rosa R

Patient Preference and Adherence 2016, 10:135-145

Published Date: 9 February 2016

The importance of inhaler devices: the choice of inhaler device may lead to suboptimal adherence in COPD patients

Darbà J, Ramírez G, Sicras A, Francoli P, Torvinen S, Sánchez-de la Rosa R

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:2335-2345

Published Date: 29 October 2015

Disability-adjusted life years lost due to diabetes in France, Italy, Germany, Spain, and the United Kingdom: a burden of illness study

Darbà J, Kaskens L, Detournay B, Kern W, Nicolucci A, Orozco-Beltrán D, Ramírez de Arellano A

ClinicoEconomics and Outcomes Research 2015, 7:163-171

Published Date: 23 March 2015

Budget impact analysis of the fentanyl buccal tablet for treatment of breakthrough cancer pain

Darbà J, Kaskens L, Sánchez-de la Rosa R

ClinicoEconomics and Outcomes Research 2014, 6:1-9

Published Date: 16 December 2013

Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain

Darbà J, Pérez-Álvarez N, Kaskens L, Holgado-Pérez S, Racketa J, Rejas J

ClinicoEconomics and Outcomes Research 2013, 5:327-336

Published Date: 5 July 2013

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010