Evidence map›Paper›PMID 41979825›Full record

ArticlePharmacoEconomics - open2026

Cost-Effectiveness of Biosimilar Denosumab Versus Bisphosphonates in Postmenopausal Osteoporosis.

Jeanine Flanigan, Sarah Kane, Fatemeh Mirzayeh Fashami, Anna Zhou, Lamees Almuallem, Mike Tindal, Marion Schauf, Edward Li, Gary H Lyman

Abstract read
In one paragraph

Article in PharmacoEconomics - open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The cost-effectiveness of biosimilar denosumab in postmenopausal osteoporosis: implications of baseline fracture risk and drug price.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jeanine FlaniganSandoz Inc, 100 College Road West, Princeton, NJ, 08540, USA.ORCID http://orcid.org/0000-0002-3813-7921
Sarah KaneValue and Evidence, EVERSANA, 204-3228 South Service Road, Burlington, ON, L7N 3H8, Canada.ORCID http://orcid.org/0009-0006-9341-4836
Fatemeh Mirzayeh FashamiValue and Evidence, EVERSANA, 204-3228 South Service Road, Burlington, ON, L7N 3H8, Canada.ORCID http://orcid.org/0000-0003-0189-9065
Anna ZhouValue and Evidence, EVERSANA, 204-3228 South Service Road, Burlington, ON, L7N 3H8, Canada.ORCID http://orcid.org/0000-0001-5451-4670
Lamees AlmuallemValue and Evidence, EVERSANA, 204-3228 South Service Road, Burlington, ON, L7N 3H8, Canada.ORCID http://orcid.org/0009-0000-3847-6766
Mike TindalSandoz Inc, 100 College Road West, Princeton, NJ, 08540, USA.ORCID http://orcid.org/0000-0002-4487-6595
Marion SchaufSandoz International GmbH, Industriestr. 25, 83607, Holzkirchen, Bayern, Germany.ORCID http://orcid.org/0009-0009-0782-8816
Edward LiSandoz Inc, 100 College Road West, Princeton, NJ, 08540, USA. edward-1.li@sandoz.com.ORCID http://orcid.org/0000-0001-8661-0560
Gary H LymanDuke University School of Medicine, 2424 Erwin Rd, Box 2736, Durham, NC, 27705, USA.ORCID http://orcid.org/0000-0002-0823-8086

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesPostmenopausal osteoporosis (PMO) is a major public health and economic burden in the USA. The objective of this study was to evaluate the cost-effectiveness of biosimilar denosumab compared with alendronate, risedronate, ibandronate, and zoledronic acid in treating women with PMO at high risk of fracture from a US payer perspective.

methodsA cost-effectiveness analysis was conducted using a Markov cohort model and a lifetime horizon was applied to capture long-term costs and effects. Treatment effects were based on published network meta-analyses. The cost of biosimilar denosumab was estimated on the basis of assumptions; other costs were obtained from publicly available sources. Main outcomes included quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs).

resultsBiosimilar denosumab was associated with greater efficacy and higher costs versus all comparators. Over a lifetime horizon, the ICER was $101,017, $93,544, $100,515, and $144,995 per QALY gained for biosimilar denosumab compared with alendronate, risedronate, ibandronate, and zoledronic acid, respectively. Cost-effectiveness was most sensitive to starting age, discount rate, treatment duration, and biosimilar price. At a willingness-to-pay (WTP) threshold of $150,000 per QALY gained, biosimilar denosumab was likely to be cost-effective compared with alendronate, risedronate, ibandronate, and zoledronic acid in the treatment of PMO. At a WTP threshold of $100,000 per QALY gained, biosimilar denosumab was likely to be cost-effective relative to risedronate, while ICERs relative to alendronate and ibandronate only marginally exceeded this WTP threshold.

conclusionsBiosimilar denosumab was estimated to be cost-effective compared with alendronate, risedronate, ibandronate, and zoledronic acid at a WTP threshold of $150,000/QALY gained and compared with risedronate at a threshold of $100,000/QALY gained. As a lower-cost alternative to reference denosumab, biosimilar denosumab may enhance patient access to effective PMO treatment in the USA.

Identifiers

PMID41979825
PMCPMC13379562

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.