Cost-effectiveness of sequential treatment with abaloparatide followed by alendronate vs. alendronate monotherapy in women at increased risk of fracture: A US payer perspective

Mickael Hiligsmann*, Setareh A. Williams, Lorraine A. Fitzpatrick, Stuart S. Silverman, Richard Weiss, Jean-Yves Reginster

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)

Abstract

Objectives: Emerging evidence supports sequential therapy with anabolic followed by antiresorptive in patients at high-risk of fragility fractures. This study assessed the cost-effectiveness of sequential treatment with abaloparatide (ABL) followed by alendronate (ALN) [(ABL/ALN)] compared to ALN monotherapy and to sequential treatment starting with antiresorptive therapy (ALN/ABL/ALN).

Methods: A previously validated Markov microsimulation model was used to estimate the cost-effectiveness of sequential ABL/ALN compared to ALN monotherapy and to sequential ALN/ABL/ALN from a lifetime US payer perspective. In line with practice guidelines, patients were assumed to receive ABL for 18 months followed by 5 years of ALN, or ALN monotherapy for 5 years, or a sequence of ALN for 2 years followed by 18 months of ABL and then by 3 years ALN. Evaluation was conducted for patients aged 50-80 years old with a BMD T-score = 1 osteoporotic fracture.

Results: Sequential ABL/ALN was cost-effective (threshold of US$150,000 per QALY) vs generic ALN monotherapy in women >= 60 years with a BMD T-score

Conclusions: Sequential ABL/ALN therapy is cost-effective vs ALN monotherapy for US postmenopausal women aged >= 60 years at increased risk of fractures. (C) 2020 The Author(s). Published by Elsevier Inc.

Original languageEnglish
Pages (from-to)394-400
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Volume50
Issue number3
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Abaloparatide
  • Alendronate
  • Economic evaluation
  • Monotherapy
  • Osteoporosis
  • Sequential treatmen
  • QUALITY-OF-LIFE
  • POSTMENOPAUSAL WOMEN
  • ORAL BISPHOSPHONATES
  • VERTEBRAL FRACTURES
  • SEVERE OSTEOPOROSIS
  • ECONOMIC-EVALUATION
  • EXCESS MORTALITY
  • UNITED-STATES
  • HIP FRACTURE
  • HEALTH

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