ArticleArchives of osteoporosis2025
A comprehensive update on the cost-effectiveness of 10-year denosumab vs alendronate in postmenopausal women with osteoporosis in the United States.
Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Denosumab Therapy in Dental Practice: Awareness, Risk Factors and Preventive Strategies.Journal of osteoporosis · 2026Review
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In postmenopausal women with osteoporosis, 10-year denosumab was estimated to be cost-effective vs 5 years of oral alendronate, a 2-year drug holiday, and subsequently 3-years of alendronate with an estimated incremental cost-effectiveness ratio of $97,574 per quality-adjusted life-years gained. Cost-effectiveness was demonstrated in most of the scenario simulations. PURPOSE: A previous economic analysis estimated that 5-year denosumab was cost-effective compared with 5-year alendronate in women with postmenopausal osteoporosis (PMO) in the United States (US). Emerging literature has provided data on the long-term clinical benefits of denosumab. Therefore, the cost-effectiveness analysis was updated to understand the potential implications of a longer treatment duration (10-year) with denosumab vs generic oral alendronate or no treatment from a US third-party payer perspective.
methodsA lifetime Markov cohort model was used to compare 10-year denosumab treatment to 5 years of alendronate, followed by a 2-year drug holiday and, then an additional 3 years of alendronate. The target population consisted of PMO women in the US with a starting age of 72 years. Recent publicly available data, including epidemiology, treatment efficacy, persistence, and costs, were used to inform model inputs. Scenario analyses and a probabilistic sensitivity analysis (PSA) were conducted to account for uncertainty.
resultsEstimated mean total lifetime cost and quality-adjusted life years (QALYs), respectively, were $81,003 and 8.035 for denosumab, and $75,358 and 7.977 for alendronate, resulting in denosumab having an incremental cost-effectiveness ratio of $97,574 per QALY gained. At a threshold of $150,000 per QALY, the PSA demonstrated that denosumab was considered cost effective in 62.1% of simulations. Denosumab was dominant over no treatment.
conclusionsTen-year denosumab treatment would be cost-effective compared with 5 years of alendronate, followed by a 2-year drug holiday and 3 years of alendronate at the threshold of $150,000. Cost-effectiveness was demonstrated across most scenarios with robust PSA results.
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