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Cost-Effectiveness of Teriparatide Compared With Alendronate and Risedronate for the Treatment of Postmenopausal Osteoporosis Patients in Iran Publisher



Azar AAEF1 ; Rezapour A2 ; Alipour V2 ; Sarabiasiabar A2 ; Gray S3 ; Mobinizadeh M4 ; Yousefvand M3 ; Arabloo J2
Authors
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Authors Affiliations
  1. 1. Medicine School, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran

Source: Medical Journal of the Islamic Republic of Iran Published:2017


Abstract

Background: Hip, vertebral and wrist fractures are the most common consequences of osteoporosis. This study aimed at analyzing the cost-effectiveness of teriparatide (CinnoPar®), compared with alendronate and risedronate, in the treatment of women aged 60 and over with postmenopausal osteoporosis in Iran. Methods: A decision tree model with a 2-year time horizon was used to compare treatment with teriparatide (CinnoPar®) with the following treatment strategies: two years of treatment with alendronate and two years of treatment with risedronate in women aged 60 years and over or those at risk of osteoporosis. Cost per QALY was calculated for 3 treatment strategies from the model. After base case analysis, one-way sensitivity analysis was performed on key parameters of the model to assess their impact on the study results and the cost-effectiveness of different treatment strategies and the model robustness. TreeAge Pro 2011 software was used for modeling and data analysis. Results: Incremental cost-effectiveness ratio (ICER) of alendronate and teriparatide than risedronate (base treatment) were US$- 2178.03 and US$483,783.67 per QALY, respectively. Therefore, the dominant and cost-effective treatment option was alendronate. In the one-way sensitivity analysis, the impact of annual 25% increase or decrease in the teriparatide cost on its ICER was remarkable. Also, reducing the discount rate from 0.03 to 0.0 had the greatest impact on the ICER of the teriparatide. Conclusion: The treatment strategy of teriparatide is more expensive than risedronate and alendronate and is associated with very little increase in QALYs. A significant reduction in teriparatide price and a limit in its use only for high-risk women and for acute and short-term treatment courses can contribute to its cost-effectiveness. © Iran University of Medical Sciences.
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