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Markov Models for Economic Evaluation in Osteoporosis Treatment

Author

Listed:
  • Marta Osca-Guadalajara

    (Hospital Universitario de la Plana, 12540 Villarreal, Spain)

  • Javier Díaz-Carnicero

    (Research Unit for Health Economics and Management, Universitat Politècnica de València, 46022 Valencia, Spain)

  • Silvia González-de-Julián

    (Research Unit for Health Economics and Management, Universitat Politècnica de València, 46022 Valencia, Spain)

  • David Vivas-Consuelo

    (Research Unit for Health Economics and Management, Universitat Politècnica de València, 46022 Valencia, Spain)

Abstract

Osteoporosis is frequent in elderly people, causing bone fractures and lowering their quality of life. The costs incurred by these fractures constitute a problem for public health. Markov chains were used to carry out an incremental cost-utility analysis of the four main drugs used in Spain to treat osteoporosis (alendronate, risedronate, denosumab and teriparatide). We considered 14 clinical transition states, from starting osteoporotic treatment at the age of 50 until death or the age of 100. Cost-effectiveness was measured by quality adjusted life years (QALYs). The values used in the Markov model were obtained from the literature. Teriparatide is the cost-effective alternative in the treatment of osteoporosis in patients with fractures from the age of 50, establishing a payment threshold of 20,000 EUR/QALY. However, it is the most expensive therapy, not appearing cost-effective in cases that do not present fracture and in ages over 80 years with fracture. Alendronate and denosumab therapies are presented as cost-effective osteoporosis treatment alternatives depending on the age of onset and duration of treatment. From the perspective of cost-effectiveness, establishing a payment threshold of 20,000 EUR/QALY, teriparatide is the cost-effective alternative in patients with fracture from the age of 50 to 70 years old in Spain.

Suggested Citation

  • Marta Osca-Guadalajara & Javier Díaz-Carnicero & Silvia González-de-Julián & David Vivas-Consuelo, 2021. "Markov Models for Economic Evaluation in Osteoporosis Treatment," Mathematics, MDPI, vol. 9(18), pages 1-20, September.
    • Handle: RePEc:gam:jmathe:v:9:y:2021:i:18:p:2331-:d:639477
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    References listed on IDEAS

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    1. Nancy Devlin & David Parkin, 2004. "Does NICE have a cost‐effectiveness threshold and what other factors influence its decisions? A binary choice analysis," Health Economics, John Wiley & Sons, Ltd., vol. 13(5), pages 437-452, May.
    2. Anju Parthan & Morgan Kruse & Nicole Yurgin & Joice Huang & Hema Viswanathan & Douglas Taylor, 2013. "Cost Effectiveness of Denosumab versus Oral Bisphosphonates for Postmenopausal Osteoporosis in the US," Applied Health Economics and Health Policy, Springer, vol. 11(5), pages 485-497, October.
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