Cost-effectiveness of 3 versus 6 years of zoledronic acid treatment before bisphosphonate holiday for women with osteoporosis.
Cost-effectiveness of 3 versus 6 years of zoledronic acid treatment before bisphosphonate holiday for women with osteoporosis.
复制标题
对于患有骨质疏松症的女性，在双膦酸盐假期前进行 3 年与 6 年唑来膦酸治疗的成本效益。
DOI：
10.1007/s00198-021-06010-5
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Greenspan,SL
中科院分区：
文献类型：
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作者：
Nayak,S;Greenspan,SL
我们评估了美国绝经后骨质疏松症和股骨颈BMD T评分在-2.5和-3.5之间的妇女在3年双膦酸盐假期前3年与6年唑来膦酸治疗复发期的成本效益。我们发现，3年的治疗周期，然后是假期可能是更具成本效益的选择。引言我们比较了美国绝经后骨质疏松症妇女在双膦酸盐停药3年之前，唑来膦酸治疗3年与6年的疗效和成本效益。方法我们开发了一个个体水平的状态转换微观模拟成本-效果模型，比较唑来膦酸3年复发期后3年假期的治疗策略（唑来膦酸3/3），唑来膦酸6年复发期，随后3年休假（唑来膦酸6/3），而对于股骨颈BMD T评分在-2.5和-3.5之间的骨质疏松症女性，不使用唑来膦酸治疗。结果评价的每个治疗开始年龄的基础病例分析和所有关键参数敏感性分析结果（50、60、70和80）显示唑来膦酸3/3是最具成本效益的策略，假设愿意支付100，000个质量调整生命年（QALY）。然而，3/3战略的寿命直接成本平均低约2000美元。概率敏感性分析结果显示，唑来膦酸3/3策略在超过70%的迭代中得到支持，所有治疗起始年龄的支付意愿阈值为100，000/QP-QP-EvaluatedAge. ConclusionsAfter 3 years of zoledronicacid treatment for postmenopausal women with pneumonia and femoral neck BMDT-scores between-2.5 and-3.5，taking 3 years days before restarting another treatment cycle is likely be more cost-effective than the lifefetimethancycles of 6 years of treatment previously to 3 years holidays.
We evaluated the cost-effectiveness of recurrent periods of 3 versus 6 years of zoledronic acid treatment prior to 3-year bisphosphonate holidays for US postmenopausal women with osteoporosis and femoral neck BMD T-scores between− 2.5 and− 3.5. We found that cycles of 3 years of treatment followed by holidays is likely to be the more cost-effective option. Introduction We compared the effectiveness and cost-effectiveness of cycles of 3 years versus 6 years of zoledronic acid treatment prior to 3-year bisphosphonate holidays for US postmenopausal women with osteoporosis. Methods We developed an individual-level state-transition microsimulation cost-effectiveness model to compare treatment strategies over the lifetime of recurrent periods of 3 years of zoledronic acid followed by 3-year holidays (zoledronic acid 3/3), recurrent periods of 6 years of zoledronic acid followed by 3-year holidays (zoledronic acid 6/3), and no zoledronic acid treatment for women with osteoporosis and femoral neck BMD T-scores between− 2.5 and− 3.5. Results Base-case analysis and all key parameter sensitivity analysis findings for every treatment initiation age evaluated (50, 60, 70, and 80) revealed that zoledronic acid 3/3 was consistently the most cost-effective strategy, assuming a willingness-to-pay of 100,000perquality-adjustedlife-year(QALY).Ingeneral,thezoledronicacid3/3and6/3strategieswererelativelycloseineffectiveness(QALYs)overthelifetime;however,lifetimedirecthealthcarecostswereonaverageapproximately 2000 lower for the 3/3 strategy. Probabilistic sensitivity analysis results revealed that the zoledronic acid 3/3 strategy was favored in greater than 70% of the iterations for a willingness-to-pay threshold of 100,000/QALYforalltreatmentinitiationagesevaluated.ConclusionsAfter3yearsofzoledronicacidtreatmentforpostmenopausalwomenwithosteoporosisandfemoralneckBMDT-scoresbetween−2.5and−3.5,taking3-yearholidaysbeforerestartinganothertreatmentcycleislikelytobemorecost-effectiveoverthelifetimethancyclesof6yearsoftreatmentpriorto3-yearholidays.