Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1395
10
1
gregorian
2017
1
1
31
1
online
1
fulltext
en
Cost-effectiveness of teriparatide compared with alendronate and risedronate for the treatment of postmenopausal osteoporosis patients in Iran
Health Technology Assessment
Health Technology Assessment
Original Research
Original Research
<p> <strong> Background: </strong>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.<br>
<strong> Methods: </strong>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.<br>
<strong> Results:</strong> 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.<br>
<strong> Conclusion:</strong> 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.<br>
</p>
Osteoporosis, Cost-effectiveness, Teriparatide, Risedronate, Alendronate, Postmenopausal Women, Fracture, Iran
224
229
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-3002-1&slc_lang=en&sid=1
Amir Ali
Ebadi Fard Azar
200319475328460033908
200319475328460033908
No
Medicine School, Iran University of Medical Sciences, Tehran, Iran.
Aziz
Rezapour
rezapoor_a57@yahoo.com
200319475328460033909
200319475328460033909
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Vahid
Alipour
vahid.alipour1360@yahoo.com
200319475328460033910
200319475328460033910
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Ali
Sarabi-Asiabar
sarabi.a@iums.ac.ir
200319475328460033911
200319475328460033911
No
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Serajaddin
Gray
seraj.1365@gmail.com
200319475328460033912
200319475328460033912
No
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mohammadreza
Mobinizadeh
mr.mobini1986@gmail.com
200319475328460033913
200319475328460033913
No
National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Mani
Yousefvand
vbutterfly60@gmail.com
200319475328460033914
200319475328460033914
No
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Jalal
Arabloo
arabloo_j64@yahoo.com
200319475328460033915
200319475328460033915
Yes
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.