The cost-effectiveness of therapy with teriparatide and alendronate in women with severe osteoporosis

DSpace/Manakin Repository

The cost-effectiveness of therapy with teriparatide and alendronate in women with severe osteoporosis

Citable link to this page

 

 
Title: The cost-effectiveness of therapy with teriparatide and alendronate in women with severe osteoporosis
Author: Liu, Hau; Michaud, Kaleb; Nayak, Smita; Karpf, David B.; Owens, Douglas K.; Garber, Alan M

Note: Order does not necessarily reflect citation order of authors.

Citation: Liu, Hau, Kaleb Michaud, Smita Nayak, David B. Karpf, Douglas K. Owens, and Alan M. Garber. 2006. The cost-effectiveness of therapy with teriparatide and alendronate in women with severe osteoporosis. Archives of Internal Medicine 166, 11: 1209-1217.
Access Status: Full text of the requested work is not available in DASH at this time (“dark deposit”). For more information on dark deposits, see our FAQ.
Full Text & Related Files:
Abstract: Background Teriparatide is a promising new agent for the treatment of osteoporosis.

Methods The objective of this study was to evaluate the cost-effectiveness of teriparatide-based strategies compared with alendronate sodium for the first-line treatment of high-risk osteoporotic women. We developed a microsimulation with a societal perspective. Key data sources include the Study of Osteoporotic Fractures, the Fracture Intervention Trial, and the Fracture Prevention Trial. We evaluated postmenopausal white women with low bone density and prevalent vertebral fracture. The interventions were usual care (UC) (calcium or vitamin D supplementation) compared with 3 strategies: 5 years of alendronate therapy, 2 years of teriparatide therapy, and 2 years of teriparatide therapy followed by 5 years of alendronate therapy (sequential teriparatide/alendronate). The main outcome measure was cost per quality-adjusted life-year (QALY).

Results For the base-case analysis, the cost of alendronate treatment was $11 600 per QALY compared with UC. The cost of sequential teriparatide/alendronate therapy was $156 500 per QALY compared with alendronate. Teriparatide treatment alone was more expensive and produced a smaller increase in QALYs than alendronate. For sensitivity analysis, teriparatide alone was less cost-effective than alendronate even if its efficacy lasted 15 years after treatment cessation. Sequential teriparatide/alendronate therapy was less cost-effective than alendronate even if fractures were eliminated during the alendronate phase, although its cost-effectiveness was less than $50 000 per QALY if the price of teriparatide decreased 60%, if used in elderly women with T scores of −4.0 or less, or if 6 months of teriparatide therapy had comparable efficacy to 2 years of treatment.

Conclusions Alendronate compares favorably to interventions accepted as cost-effective. Therapy with teriparatide alone is more expensive and produces a smaller increase in QALYs than therapy with alendronate. Sequential teriparatide/alendronate therapy appear expensive but could become more cost-effective with reductions in teriparatide price, with restriction to use in exceptionally high-risk women, or if short courses of treatment have comparable efficacy to that observed in clinical trials.
Published Version: doi:10.1001/archinte.166.11.1209
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:11563389
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)

 
 

Search DASH


Advanced Search
 
 

Submitters