Cost-effectiveness of teriparatide compared with alendronate and risedronate for the treatment of postmenopausal osteoporosis patients in Iran

Authors

  • Ali Sarabi-Asiabar Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Amir Ali Ebadi Fard Azar Medicine School, Iran University of Medical Sciences, Tehran, Iran.
  • Aziz Rezapour Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Jalal Arabloo Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Mani Yousefvand Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Serajaddin Gray Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Vahid Alipour Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
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.  

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Journal title

volume 31  issue 1

pages  224- 229

publication date 2017-01

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