VOLUME 21 - NUMBER 2 / April - June (Original article / Artículo original)
Fernando Carlos-Rivera, Departamento de Farmacoeconomía, AHS Health Consulting S.A.S. de C.V., Huixquilucan, Edo. de México, México
Jorge A. Guzmán-Caniupan, Departamento de Acceso, AHS Health Consulting S.A.S. de C.V., Huixquilucan, Edo. de México, México
Adolfo Hernández-Garduño, Área Médica, AHS Health Consulting S.A.S. de C.V., Huixquilucan, Edo. de México, México
Mónica Alva-Esqueda, Departamento de Farmacoeconomía, Amgen México S.A. de C.V., Ciudad de México, México
Therese Aubry-de Maraumont, Departamento de Economía de la Salud, Amgen México S.A. de C.V., Ciudad de México. México
Luis M. Camacho-Cordero, Departamento de Economía de la Salud, Amgen México S.A. de C.V., Ciudad de México. México
Objectives: To undertake an economic evaluation of denosumab in comparison with a mixed scenario consisted of zoledronic acid or no treatment if there is a contraindication to this agent due to severe renal impairment (Mix ZA/No tx) in patients with multiple myeloma (MM). Methods: The analysis adopted the perspective of the Mexican public health care system as a payer. This is a partitioned-survival five-stages semi-Markov model for a life-time horizon. We evaluated the frequencies of skeletal-related events (SREs) as well as the costs associated to drug acquisition/infusion, routine patient management, medical attention of SREs, treatment of serious adverse events, and anti-myeloma treatment. Results: Denosumab use was more expensive but also more effective, with incremental cost-effectiveness ratios of $13,942 Mexican pesos (MXN) per SRE avoided and $1,893 MXN per additional month of progression-free survival. In general, the model is robust. Conclusions: In patients with MM, denosumab represents a cost-effective intervention in comparison with the Mix ZA/No tx.
Keywords: Economic evaluation. Cost-effectiveness. Denosumab. Zoledronic acid. Skeletal-related events. Multiple myeloma.
