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FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures

Disclosure: M. Hiligsmann: Grant Recipient; Self; Radius Health, Inc. S. Silverman: Consulting Fee; Self; Amgen Inc, Radius Health, Inc. Grant Recipient; Self; Amgen Inc, Radius Health, Inc. A.J. Singer: Consulting Fee; Self; Agnovos, Amgen Inc, Radius Health, Inc, UCB. Speaker; Self; Amgen Inc, Rad...

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Autores principales: Hiligsmann, Mickael, Silverman, Stuart, Singer, Andrea J, Pearman, Leny, Wang, Yamei, Caminis, John N, Reginster, Jean-Yves
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555432/
http://dx.doi.org/10.1210/jendso/bvad114.450
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author Hiligsmann, Mickael
Silverman, Stuart
Singer, Andrea J
Pearman, Leny
Wang, Yamei
Caminis, John N
Reginster, Jean-Yves
author_facet Hiligsmann, Mickael
Silverman, Stuart
Singer, Andrea J
Pearman, Leny
Wang, Yamei
Caminis, John N
Reginster, Jean-Yves
author_sort Hiligsmann, Mickael
collection PubMed
description Disclosure: M. Hiligsmann: Grant Recipient; Self; Radius Health, Inc. S. Silverman: Consulting Fee; Self; Amgen Inc, Radius Health, Inc. Grant Recipient; Self; Amgen Inc, Radius Health, Inc. A.J. Singer: Consulting Fee; Self; Agnovos, Amgen Inc, Radius Health, Inc, UCB. Speaker; Self; Amgen Inc, Radius Health, Inc. L. Pearman: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. Y. Wang: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. J.N. Caminis: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. J. Reginster: Advisory Board Member; Self; Pierre Fabre. Consulting Fee; Self; IBSA-Genevrier, Mylan, Teva Pharmaceutical Industries Ltd. Speaker; Self; IBSA-Genevrier, Mylan, CNIEL, Dairy Research Council, Teva Pharmaceutical Industries Ltd. Background: Cost-effectiveness analyses are becoming increasingly important for efficiency in healthcare resource allocation. This study aims to assess the cost-effectiveness of four common treatment approaches of US men and women at very high risk of fracture: bisphosphonate (alendronate [ALN]) monotherapy, sequential treatment with an anabolic first (either abaloparatide [ABL] or teriparatide [TPTD]) followed by a bisphosphonate, and no treatment, as many patients at very high fracture risk do not receive an osteoporosis medication. Methods: A microsimulation-based Markov model was used to assess the cost-effectiveness of four treatment approaches in US women and men aged 50 to 80 years who had a recent fracture and had densitometry-confirmed osteoporosis (bone mineral density T-score ≤−2.5): ALN monotherapy, sequential ABL/ALN, sequential unbranded TPTD/ALN, and no treatment. Analyses were conducted from the US healthcare decision-maker perspective using $2022 costs, and health outcomes were expressed in quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were performed to characterize uncertainty. Results: In both sexes and over the full age range, no treatment and sequential unbranded TPTD/ALN were dominated (ie, they had lower QALYs for more costs than a comparator treatment), and should be excluded. Sequential ABL/ALN was associated with more QALYs and more costs than ALN monotherapy. At the US threshold of $150,000 per QALY gained, sequential ABL/ALN was cost-effective compared to ALN monotherapy in men aged ≥50 years and in women aged ≥65 years. Sensitivity analyses suggested that sequential ABL/ALN was also cost-effective in women with a recent hip or vertebral fracture aged ≥55 years. Conslusion: In both US men (aged ≥50 years) and women (aged ≥65 years) at very high risk of fracture, sequential ABL/ALN is the most cost-effective intervention among the four treatment approaches. Sequential unbranded TPTD/ALN and no treatment were dominated, and are thus not efficient treatment approaches. Treating US men and women at very high fracture risk with sequential ABL/ALN leads to an efficient resource allocation. Presentation: Friday, June 16, 2023
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spelling pubmed-105554322023-10-06 FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures Hiligsmann, Mickael Silverman, Stuart Singer, Andrea J Pearman, Leny Wang, Yamei Caminis, John N Reginster, Jean-Yves J Endocr Soc Bone And Mineral Metabolism Disclosure: M. Hiligsmann: Grant Recipient; Self; Radius Health, Inc. S. Silverman: Consulting Fee; Self; Amgen Inc, Radius Health, Inc. Grant Recipient; Self; Amgen Inc, Radius Health, Inc. A.J. Singer: Consulting Fee; Self; Agnovos, Amgen Inc, Radius Health, Inc, UCB. Speaker; Self; Amgen Inc, Radius Health, Inc. L. Pearman: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. Y. Wang: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. J.N. Caminis: Employee; Self; Radius Health, Inc. Stock Owner; Self; Radius Health, Inc. J. Reginster: Advisory Board Member; Self; Pierre Fabre. Consulting Fee; Self; IBSA-Genevrier, Mylan, Teva Pharmaceutical Industries Ltd. Speaker; Self; IBSA-Genevrier, Mylan, CNIEL, Dairy Research Council, Teva Pharmaceutical Industries Ltd. Background: Cost-effectiveness analyses are becoming increasingly important for efficiency in healthcare resource allocation. This study aims to assess the cost-effectiveness of four common treatment approaches of US men and women at very high risk of fracture: bisphosphonate (alendronate [ALN]) monotherapy, sequential treatment with an anabolic first (either abaloparatide [ABL] or teriparatide [TPTD]) followed by a bisphosphonate, and no treatment, as many patients at very high fracture risk do not receive an osteoporosis medication. Methods: A microsimulation-based Markov model was used to assess the cost-effectiveness of four treatment approaches in US women and men aged 50 to 80 years who had a recent fracture and had densitometry-confirmed osteoporosis (bone mineral density T-score ≤−2.5): ALN monotherapy, sequential ABL/ALN, sequential unbranded TPTD/ALN, and no treatment. Analyses were conducted from the US healthcare decision-maker perspective using $2022 costs, and health outcomes were expressed in quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were performed to characterize uncertainty. Results: In both sexes and over the full age range, no treatment and sequential unbranded TPTD/ALN were dominated (ie, they had lower QALYs for more costs than a comparator treatment), and should be excluded. Sequential ABL/ALN was associated with more QALYs and more costs than ALN monotherapy. At the US threshold of $150,000 per QALY gained, sequential ABL/ALN was cost-effective compared to ALN monotherapy in men aged ≥50 years and in women aged ≥65 years. Sensitivity analyses suggested that sequential ABL/ALN was also cost-effective in women with a recent hip or vertebral fracture aged ≥55 years. Conslusion: In both US men (aged ≥50 years) and women (aged ≥65 years) at very high risk of fracture, sequential ABL/ALN is the most cost-effective intervention among the four treatment approaches. Sequential unbranded TPTD/ALN and no treatment were dominated, and are thus not efficient treatment approaches. Treating US men and women at very high fracture risk with sequential ABL/ALN leads to an efficient resource allocation. Presentation: Friday, June 16, 2023 Oxford University Press 2023-10-05 /pmc/articles/PMC10555432/ http://dx.doi.org/10.1210/jendso/bvad114.450 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Bone And Mineral Metabolism
Hiligsmann, Mickael
Silverman, Stuart
Singer, Andrea J
Pearman, Leny
Wang, Yamei
Caminis, John N
Reginster, Jean-Yves
FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title_full FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title_fullStr FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title_full_unstemmed FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title_short FRI682 Cost Effectiveness Of Four Treatment Approaches For US Women And Men At Very High Risk Of Osteoporotic Fractures
title_sort fri682 cost effectiveness of four treatment approaches for us women and men at very high risk of osteoporotic fractures
topic Bone And Mineral Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10555432/
http://dx.doi.org/10.1210/jendso/bvad114.450
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