Economic Evaluation of Denosumab for Treatment of  Postmenopausal Osteoporosis: A Systematic Review

Shahin  Nargesi; Saeed  Husseini Barghazan; Nadia  Sani'ee; Asma Rashki  Kemmak

doi:10.18502/ijph.v51i7.10084

Shahin Nargesi Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
Saeed Husseini Barghazan Department of Health Economic, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Nadia Sani'ee Department of Medical Library and Information Sciences, Student Research Committee, Iran University of Medical Sci-ences, Tehran, Iran
Asma Rashki Kemmak Department of Health Economic, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v51i7.10084

Keywords: Cost benefit analysis; Denosumab; Osteoporosis; Postmenopausal; Systematic review

Abstract

Background: We aimed to review the systematic economic evaluation of denosumab versus than alternative drugs and oral bisphosphonates of postmenopausal osteoporosis in women and help health system policy makers for prioritizing and optimally allocate limited health resources.

Methods: We examined the databases of PubMed, Web of Science, Embase, Scopus, Cochrane Library, ProQuest. Strategy search was designed based on keywords. Inclusion criteria were: studies that conducted economic evaluation denosumab compared to oral bisphosphonates for the treatment of osteoporosis in postmenopausal women. Cost-effectiveness studies conducted using decision analysis models based on the economic evaluation approach; studies with available full-text papers; and studies written in English and published between 2010 and 2020. After selecting articles based on inclusion and exclusion criteria, data were extracted and the results were summarized. The quality of the articles was evaluated using the CHEERS checklist.

Results: Among 214 initial studies, 8 studies met the inclusion criteria. Most studies focused on the cost-effectiveness of denosumab compared with oral bisphosphonates for the treatment of osteoporosis. The study agreed interval ranged from 3 months to 5 years. The costs investigated in the studies were direct medical costs. In most studies, the use of denosumab significantly prevented fractures.

Conclusion: Denosumab is generally more cost-effective than alternative drugs and oral bisphosphonates (alendronate, risedronate, strontium ranelate, ibandronate, and untreated).