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
Objective: To evaluate denosumab economically compared with a mixed scenario of zoledronic acid or no treatment if there is contraindication to such agent due to severe kidney impairment (Mix ZA/No Trt) in patients with solid tumors (ST) with bone metastasis. Method: It is a cost-effectiveness analysis based on a Markov model with a lifetime horizon, under the IMSS perspective. We evaluated the frequencies of skeletal-related events (SREs) as well as the costs associated to drug acquisition, intravenous infusion of ZA, routine patient management, medical attention of SREs, and treatment of serious adverse events. Results: In the base-case, denosumab resulted dominant over Mix ZA/No Trt, with mean savings of $2,494 Mexican pesos and 0.781 SREs avoided per patient. If ZA is given every 12 weeks, denosumab would not be dominant, but cost-effective. Denosumab was either dominant or cost-effective in 74.7% of the simulations. Conclusions: In patients with ST with bone metastasis, denosumab represents a dominant or at least a cost-effective intervention in comparison with Mix ZA/No Trt.
Keywords: Economic evaluation. Cost-effectiveness. Denosumab. Zoledronic acid. Skeletal-related events. Solid tumors.
