罗莫索单抗治疗墨西哥极高骨折风险的严重绝经后骨质疏松症的成本效益。

Juan Pablo Diaz Martinez, Therese Aubry de Maraumont, Elly Natty Sánchez, Luis Miguel Camacho Cordero, Eric Yeh
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引用次数: 0

摘要

研究简介本研究旨在评估罗莫索单抗与特立帕肽(均与地诺索单抗排序)治疗墨西哥女性骨折风险极高的严重绝经后骨质疏松症的成本效益。研究方法采用马尔可夫模型评估罗莫索单抗治疗 1 年与特立帕肽治疗 2 年的相对成本效益。对平均年龄为 74 岁、T 评分为 -2.5 且曾发生过脆性骨折的女性群体的终生结果进行了模拟。分析从墨西哥医疗保健系统的角度进行,使用的贴现率为每年 5%。为了解相对骨折发生率,利用骨质疏松症治疗试验元回归提供的关系,将罗莫单抗相对于特立帕肽的骨矿密度(BMD)优势转化为骨折的相对风险。结果以终生成本(2023 墨西哥比索)、质量调整生命年(QALYs)和获得的生命年(LYs)进行评估。结果显示基础病例结果显示,与特立帕肽/地诺单抗相比,罗莫单抗/地诺单抗可使每位患者的成本降低 51,363 墨西哥比索,并可增加 0.03 个 QALYs 和 0.01 个 LYs。情景分析和概率敏感性分析证实,结果对模型假设和输入的不确定性具有稳健性。结论结果表明,与特立帕肽/地诺单抗相比,罗莫索单抗/地诺单抗能以更低的总成本产生更大的健康效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-effectiveness of romosozumab for severe postmenopausal osteoporosis at very high risk of fracture in Mexico.
Introduction: This study aims to assess the cost effectiveness of romosozumab versus teriparatide, both sequenced to denosumab, for the treatment of severe postmenopausal osteoporosis at very high risk of fractures in Mexican women. Methods: A Markov model was used to assess the relative cost effectiveness of 1 year of romosozumab versus 2 years of teriparatide, both sequenced to denosumab for a total treatment duration of 5 years. Outcomes for a cohort of women with a mean age of 74 years, a T-score -2.5 and a previous fragility fracture were simulated over a lifetime horizon. The analysis was conducted from the perspective of the Mexican healthcare system and used a discount rate of 5% per annum. To inform relative fracture incidence, the bone mineral density (BMD) advantage of romosozumab over teriparatide was translated into relative risks of fracture, using relationships provided by a meta-regression of osteoporosis therapy trials. Outcomes were assessed in terms of lifetime costs (2023 Mexican pesos), quality-adjusted life years (QALYs) and life-years gained (LYs). Results: Base case results showed that, compared with teriparatide/ denosumab, romosozumab/ denosumab reduced costs by $51,363 MXN per patient and yielded 0.03 additional QALYs and 0.01 LYs. Scenario analyses and probabilistic sensitivity analyses confirmed that results are robust to uncertainty in model assumptions and inputs. Conclusions: Results show that romosozumab/ denosumab produces greater health benefits at a lower total cost than teriparatide/ denosumab.
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