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Cost effectiveness of romosozumab versus teriparatide for severe postmenopausal osteoporosis in Japan

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Abstract

Summary

This study assessed the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japan, using bone mineral density (BMD) efficacy data. Results show that romosozumab/alendronate produces greater health benefits at a lower cost than teriparatide/alendronate.

Introduction

This study aims to assess the cost effectiveness of romosozumab versus teriparatide, both sequenced to alendronate, for the treatment of severe postmenopausal osteoporosis in Japanese women previously treated with bisphosphonates.

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 alendronate for a total treatment duration of 5 years. Outcomes for a cohort of women with a mean age of 78 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 Japanese healthcare system and used a discount rate of 2% 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 (2020 US dollars) and quality-adjusted life years (QALYs).

Results

Base case results showed that, compared with teriparatide/alendronate, romosozumab/alendronate reduced costs by $5134 per patient and yielded 0.045 additional QALYs. Scenario analyses and probabilistic sensitivity analysis confirmed that results are robust to uncertainty in model assumptions and inputs.

Conclusion

Results show that romosozumab/alendronate produces greater health benefits at a lower total cost than teriparatide/alendronate.

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Funding

This study was funded by Amgen Europe GmbH.

Author information

Authors and Affiliations

  1. Tottori University, Tottori, Japan

    H. Hagino

  2. Kobe Gakuin University, Kobe, Japan

    K. Tanaka

  3. Cedars Sinai, Los Angeles, CA, USA

    S. Silverman

  4. Oregon Osteoporosis Center, Portland, OR, USA

    M. McClung

  5. Mary McKillop Center for Health Research, Australian Catholic University, Melbourne, Australia

    M. McClung

  6. Amgen Inc., Thousand Oaks, CA, USA

    S. R. Gandra

  7. UCB BioPharma SPRL., Brussels, Belgium

    M. Charokopou

  8. Amgen K.K., Tokyo, Japan

    K. Adachi

  9. Amgen Ltd., Uxbridge, UK

    B. Johnson

  10. Amgen GmbH, Rotkreuz, Switzerland

    B. Stollenwerk

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  1. H. Hagino
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Corresponding author

Correspondence to B. Johnson.

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Conflicts of interest

HH has received grant/research support from Asahi Kasei Pharma, Astellas, Chugai, Eisai, Mitsubishi Tanabe Pharma, Pfizer Japan, Taisho and Teijin Pharma, has provided consultancy services to Asahi Kasei Pharma, and has received speaking fees from Amgen, Asahi Kasei Pharma, Astellas, Chugai, Eisai, Eli Lilly Japan, Mitsubishi Tanabe Pharma, Mochida, MSD, Pfizer Japan, Taisho, Teijin Pharma, and UCB Japan. SS has received grant/research support from Amgen and Radius, has provided consultancy services to Amgen, Radius, Lilly, and Pfizer, and has received speakers’ bureau from Amgen and Radius. MM has provided consultancy services to Amgen and Myovant and has received speakers’ bureau from Amgen. SRG, KA, BJ, and BS are employees of Amgen and own Amgen stock. MC is an employee of UCB BioPharma. KT has no conflicts of interest to declare.

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Hagino, H., Tanaka, K., Silverman, S. et al. Cost effectiveness of romosozumab versus teriparatide for severe postmenopausal osteoporosis in Japan. Osteoporos Int 32, 2011–2021 (2021). https://doi.org/10.1007/s00198-021-05927-1

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  • DOI: https://doi.org/10.1007/s00198-021-05927-1

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